Hand-assisted laparoscopic colorectal surgery (HALS) at a community hospital

Abstract

Hand-assisted laparotomy colectomy is a safe and effective procedure. The data in terms of length of hospital stay and operative time compare favorably with published data for conventional laparoscopic (CL) colectomy. Although further study is necessary, it appears that HALS confers all of the advantages of CL for colectomy, with no obvious drawbacks.

Hand-assisted versus laparoscopic-assisted colorectal surgery: Practice patterns and clinical outcomes in a minimally-invasive colorectal practice

“…The perioperative clinical outcomes of our patients undergoing HALS compared favorably with those reported in other contemporary HALS series for benign and malignant colorectal diseases [1,10,11,14]. In 2006, Schadde et al [11] reported 104 patients who underwent HALS over a five-year period for a variety of colorectal indications.…”

“…In 2006, Schadde et al [11] reported 104 patients who underwent HALS over a five-year period for a variety of colorectal indications. In this study, which at that time was the largest published HALS colectomy series, the mean patient age was 61 years and the majority (50%) had left-sided resections for diverticular disease.…”

“…Several studies have examined the applicability of this technique to specific advanced colorectal procedures [9,10] but few have analyzed the role of HALS in a clinical practice involving patients with a variety of benign and malignant colorectal diseases [10][11][12][13]. Although available randomized comparisons of HALS versus LA have suggested that HALS maintains the patient-related benefits of LA colectomy while shortening operative times and allowing surgeons to perform more complex cases [1,14] these studies suffered from small sample sizes.…”

Robotic tumor-specific mesorectal excison of rectal cancer: short-term outcome of a pilot randomized trial

“…However, conversion will occur as more R-TSME cases are managed. In these cases, hand-assisted laparoscopic surgery (HALS) will be a useful alternative approach to open conversion because HALS preserves the features of a minimally invasive approach as well as its advantages including diminished postoperative pain, faster return of bowel movement, and faster return to normal activity [26,27].…”

Hand-Assisted Laparoscopic vs. Laparoscopic Colorectal Surgery: A Multicenter, Prospective, Randomized Trial

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] However, critics point out that it is difficult to draw meaningful conclusions from these trials because: many were retrospective; or if randomized, they involved a single institution or had multiple surgeons performing a wide array of procedures. There also has been an evolution in handassist technology in the past several years.…”