Hand-Assisted Laparoscopy

Abstract

Placement of the hand-assistance device depends on the device being used. As opposed to the original handassistance devices, the current ones are placed before creating the pneumoperitoneum. The manufacturer’s instructions are usually pretty clear, and they should be followed carefully. If you are cavalier about it and don’t learn the specifics for insertion of each device, you will struggle a lot. There are particular tricks for applying each individual device. For the Lap Disc®, placing two stay sutures helps considerably. For the Gelport®, rolling the wound protector edge to the right distance and getting the first “snap” of the cap on firmly are important. For the Omniport®, it is easier to place both rings into the abdomen, and then pull the outer one out, than it is to place the inner one inside the abdomen and the outer one outside initially.