title: Use of the surgical towel in colorectal hand-assisted laparoscopic surgery (HALS).
abstract: The use of laparotomy pads or towels to displace the small intestine away from the operative site is a well-established technique in open surgery; however, its application is unfeasible or extremely challenging in standard laparoscopic surgery. We describe the use of standard surgical towels in hand-assisted laparoscopic surgery (HALS). A Pfannenstiel incision is made and a Gelport hand-access device is assembled. A sterilized surgical towel, 65 x 44 cm in size, is inserted via the Gelport, unfolded, and placed over the bowel loops laparoscopically with the assistance of the hand. The bowel loops are then housed gently in the towel and displaced away from of the operative site. HALS enables the easy insertion and handling of a large surgical towel inside the peritoneal cavity. The towel successfully retracts the small intestine, enabling the surgeon to concentrate the use of his or her hand on the targeted structures. This practical and inexpensive tip adds another advantageous component to the practice of colorectal HALS.
authors.affiliation: Section of Colon and Rectal Surgery, Department of Surgery, Weill Medical College of Cornell University-New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10021, USA.
authors.forename: K
authors.initials: K
authors.lastname: Nakajima
authors.forename: J W
authors.initials: JW
authors.lastname: Milsom
authors.forename: D A
authors.initials: DA
authors.lastname: Margolin
authors.forename: E J
authors.initials: EJ
authors.lastname: Szilagy
mesh_terms: D001512:Bedding and Linens; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D006225:Hand; D006801:Humans; D007421:Intestine, Small; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D012007:Rectum / Q000601:surgery*