title: Two-handed assisted laparoscopic surgery: Evaluation in an animal model.
abstract: OBJECTIVE
  To evaluate in an animal model the feasibility of a novel concept of hand-assisted surgery consisting of inserting two hands into the abdomen instead of one. The chosen procedure was retroperitoneal lymph node dissection (L-RPLND) that was performed in five pigs.
  
  
  METHODS
  A Pfannestiel and a transverse epigastric incisions were made through which both hands were introduced. The scope was inserted through the umbilicus. The colon was moved medially and the dissection was performed as in open surgery using short conventional surgical instruments.
  
  
  CONCLUSIONS
  The surgery was fulfilled easily and safely in quite a similar way as in open surgery. Two-handed laparoscopy may be indicated in cases that still today require an open approach as apparently makes the operation easier and significantly shortens the surgery time. However, new opinions and trials are required.
authors.affiliation: Department of Surgery, School of Medicine, Malaga, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sanchez-de-Badajoz
authors.affiliation: Department of Surgery, School of Medicine, Malaga, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Sanchez-Gallegos
authors.affiliation: Department of Surgery, School of Medicine, Malaga, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Martinez-Moreno
mesh_terms: D000818:Animals; D005240:Feasibility Studies; D058733:Hand-Assisted Laparoscopy / Q000379:methods*; D007668:Kidney / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008488:Medical Illustration; D023421:Models, Animal; D010537:Peritoneum / Q000601:surgery; D015203:Reproducibility of Results; D012187:Retroperitoneal Space / Q000601:surgery; D013552:Swine