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

A prospective analysis of 104 consecutive cases

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Abstract

Background

We report 104 consecutive cases of hand-assisted laparoscopic (HAL) colectomy over 5 years performed by a single surgeon.

Methods

Data were gathered prospectively and include patient demographic data, diagnosis, operating time, conversion rate, length of hospital stay, and complications. Virtually all patients presenting for elective resection with benign disease and metastatic cancer were treated using HAL techniques.

Results

The mean age was 61 years; 48% of patients had diverticulitis; 21%, colorectal cancer; 18%, benign polyps. In addition, 55% of patients underwent sigmoid or left colectomy; 27%; right hemicolectomy; 9%, low anterior resection, and two double resections were performed. Mean operating room time was 135 minutes; in 12% of the patients conversion to open surgery became necessary, in most cases requiring only a small extension of the HAL incision. Mean and median discharge was postoperative day 4 and postoperative day 3, respectively. There was 1 death (1%) and 21% of patients had complications, 12% of them major.

Conclusions

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.

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References

  1. Begos DG, Arsenault J, Ballantyne GH (1996) Laparoscopic colon and rectal surgery at a VA hospital. Analysis of the first 50 cases. Surg Endosc 10: 1050–1056

    Article  PubMed  CAS  Google Scholar 

  2. Cobb WS, Lokey JS, Schwab DP, Crockett JA, Rex JC, Robbins JA (2003) Hand-assisted laparoscopic colectomy: a single-institution experience. Am Surg 69: 578–580

    PubMed  Google Scholar 

  3. Darzi A (2000) Hand-assisted laparoscopic colorectal surgery. Surg Endosc 14: 999–1004

    Article  PubMed  CAS  Google Scholar 

  4. Darzi A (2001) Hand-assisted laparoscopic colorectal surgery. Semin Laparosc Surg 8: 153–160

    Article  PubMed  CAS  Google Scholar 

  5. The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopic ally assisted and open colectomy for colon cancer. N Engl J Med 350: 2050–2059

    Article  Google Scholar 

  6. Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1: 144–150

    PubMed  CAS  Google Scholar 

  7. Khalili TM, Fleshner PR, Hiatt JR, Sokol TP, Manookian C, Tsushima G, Phillips EH (1998) Colorectal cancer: comparison of laparoscopic with open approaches. Dis Colon Rectum 41: 832–838

    Article  PubMed  CAS  Google Scholar 

  8. Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363: 1187–1192

    Article  PubMed  Google Scholar 

  9. Litwin DE, Darzi A, Jakimowicz J, Kelly JJ, Arvidsson D, Hansen P, Callery MP, Denis R, Fowler DL, Medich DS, O’Reilly MJ, Atlas H, Himpens JM, Swanstrom LL, Arous EJ, Pattyn P, Yood SM, Ricciardi R, Sandor A, Meyers WC (2000) Hand-assisted laparoscopic surgery (HALS) with the HandPort system: initial experience with 68 patients. Ann Surg 231: 715–723

    Article  PubMed  CAS  Google Scholar 

  10. Muckleroy SK, Ratzer ER, Fenoglio ME (1999) Laparoscopic colon surgery for benign disease: a comparison to open surgery. JSLS 3: 33–37

    PubMed  CAS  Google Scholar 

  11. Ramos JM, Beart RW Jr, Goes R, Ortega AE, Schlinkert RT (1995) Role of laparoscopy in colorectal surgery. A prospective evaluation of 200 cases. Dis Colon Rectum 38: 494–501

    Article  PubMed  CAS  Google Scholar 

  12. Romanelli JR, Kelly JJ, Litwin DE (2001) Hand-assisted laparoscopic surgery in the United States: an overview. Semin Laparosc Surg 8: 96–103

    Article  PubMed  CAS  Google Scholar 

  13. Schwenk W, Bohm B, Muller JM (1998) Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. A prospective randomized trial. Surg Endosc 12: 1131–1136

    Article  PubMed  CAS  Google Scholar 

  14. Targarona EM, Gracia E, Garriga J, Martinez-Bru C, Cortes M, Boluda R, Lerma L, Trias M (2002) Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy: applicability, immediate clinical outcome, inflammatory response, and cost. Surg Endosc 16: 234–239

    Article  PubMed  CAS  Google Scholar 

  15. Targarona EM, Gracia E, Rodriguez M, Cerdan G, Balague C, Garriga J, Trias M (2003) Hand-assisted laparoscopic surgery. Arch Surg 138: 133–141; discussion 141

    Article  PubMed  Google Scholar 

  16. Wexner SD, Cohen SM (1995) Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82: 295–298

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, New England Medical Center/Tufts University School of Medicine, 750 Washington St., Boston, MA, 02111, USA

    E. Schadde & D. Smith

  2. Kaiser Hospital, 27400 Hesperian Boulevard, Hayward, CA, 94545, USA

    A. S. Alkoraishi

  3. Commonwealth Surgical Associates, 91 Montvale Avenue, Suite 208, Stoneham, MA, 02180, USA

    D. G. Begos

Authors
  1. E. Schadde
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  2. D. Smith
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  3. A. S. Alkoraishi
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  4. D. G. Begos
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Corresponding author

Correspondence to D. G. Begos.

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Schadde, E., Smith, D., Alkoraishi, A.S. et al. Hand-assisted laparoscopic colorectal surgery (HALS) at a community hospital. Surg Endosc 20, 1077–1082 (2006). https://doi.org/10.1007/s00464-006-2002-3

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  • DOI: https://doi.org/10.1007/s00464-006-2002-3

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