Hand-assisted laparoscopic surgery of abdominal large visceral organs.
OBJECTIVE
To design a hand-assisted laparoscopic approach in an attempt to provide an option for laparoscopic resection of abdominal large viscera.


METHODS
A 5-6 cm incision (for HandPort) and 2 trocars were employed. The main vessel of the target organ was taken as a "core", and all tissues around the core were taken as peripheral structures. The peripheral structures were dissected first, and the core vessels were treated last. Twenty-six patients underwent laparoscopic deroofing of the hepatic huge cysts, resection of the segments lying at the outer edge of the liver (segments 2 to 6), splenectomy, hemicolectomy, ileocecectomy and subtotal gastrectomy with HandPort device, harmonic scalpel, or Ligasure.


RESULTS
The duration of the procedure was within 2 h. Blood loss amounted to 8-120 mL. The conversion rate was 3.8% (1/26). All patients had uneventful postoperative courses with less pain, earlier oral intake, and faster recovery, compared with conventional surgery.


CONCLUSIONS
This method combines the advantages of both open and laparoscopic techniques, achieving better hemostasis effect, shortening the operative time, and is beneficial to the patients.
Dai
Li-Hua
LH
Department of Surgery, The First Hospital of Guangzhou,1 Panfu Road, Guangzhou 510180, Guangdong Province, China. stswhz@zsu.edu.cn
Xu
Bo
B
Zhu
Guang-Hui
GH
D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007422:Intestines / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000601:surgery*; D013156:Splenectomy / Q000379:methods; D013270:Stomach / Q000601:surgery*