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Hand-assisted laparoscopic surgery (HALS): a report of 150 procedures

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Abstract

Background: This study was performed to evaluate the (long-term) morbidity associated with hand-assisted laparoscopic surgery (HALS) for various indications. Methods: HALS procedures for various indications were evaluated prospectively from 1995 to 2002. The primary outcome parameters were postsurgical complications and the development of incisional hernias. Results: Twenty-six splenectomies, 51 hand-assisted laparoscopic donor nephrectomies (HLDN), 34 segmental bowel resections, 29 proctocolectomies, and 10 emergency colectomies were evaluated. A Küstner or Pfannenstiel incision was used for handport placement. Minor complications (i.e., wound complications, urinary tract infection) occurred in 15%, 12%, 26%, 7%, and 33% of the patients after, respectively, splenectomy, HLDN, bowel resection, proctocolectomy, and emergency colectomy. Major complications (i.e., hemorrhage, anastomotic leakage) occurred in 15% and 12% of the patients after, respectively, bowel resection and proctocolectomy. Incisional hernias occurred in six patients (4%), all after a wound complication in the Küstner incision. Conclusion: HALS is fast, safe, and feasible for various indications, especially HLDN and (procto-)colectomies. Little advantage can be expected when HALS is applied in splenectomy and segmental bowel (sigmoid) resection.

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Correspondence to W. A. Bemelman.

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Maartense, S., Bemelman, W., Gerritsen van der Hoop, A. et al. Hand-assisted laparoscopic surgery (HALS): a report of 150 procedures . Surg Endosc 18, 397–401 (2004). https://doi.org/10.1007/s00464-003-9030-z

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Keywords

  • Hand-assisted laparoscopic surgery (HALS)
  • Splenectomy
  • Donor nephrectomy
  • Proctocolectomy
  • Bowel resection
  • Morbidity