Hand-assisted laparoscopic surgery (HALS): a useful technique for complex laparoscopic abdominal procedures.

Advanced laparoscopic abdominal surgery is now being performed routinely. However, it can be extremely challenging and time-consuming, and it may be associated with increased intraoperative and postoperative complications, mainly due to the loss of tactile sensation with totally laparoscopic techniques. This article describes a technique of hand-assisted laparoscopic surgery for complex abdominal procedures that allows the surgeon to insert a nondominant hand into the abdominal cavity while preserving the pneumoperitoneum. Use of the hand allows for rapid exploration, methodical dissection, identification of crucial structures, and expeditious performance of a procedure because of the maintenance of the tactile sensation. Our experience with this approach has been favorable.

[1]  M. Memon,et al.  The role of minimal access surgery in the acute abdomen. , 1997, The Surgical clinics of North America.

[2]  W. Bemelman,et al.  Laparoscopic-assisted colectomy with the dexterity™ pneumo sleeve , 1996, Diseases of the colon and rectum.

[3]  R. Fitzgibbons,et al.  Laparoscopic resection of heterotopic gastric pancreatic tissue. , 1997, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[4]  B. Schirmer.  Laparoscopic colon resection. , 1996, The Surgical clinics of North America.

[5]  S. Harris.  Laparoscopic antireflux surgery. , 1996, American journal of surgery.

[6]  M. Memon,et al.  Laparoscopic closure of acutely perforated duodenal ulcer--an early experience. , 1993, Irish medical journal.

[7]  J R Monson,et al.  Advanced techniques in abdominal surgery. , 1993, BMJ.

[8]  M. Gagner,et al.  Laparoscopically assisted gastric surgery using Dexterity Pneumo Sleeve , 1997, Surgical Endoscopy.

[9]  H. Nord,et al.  Complications of Laparoscopy , 1992, Endoscopy.

[10]  G. Kopchok,et al.  Endoscopic surgery training: application of an in vitro trainer and in vivo swine model. , 1993, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[11]  Barak Gaster,et al.  The Learning Curve , 1993 .

[12]  E. Weiss,et al.  Intraoperative laparoscopic complications , 1996, Diseases of the colon and rectum.

[13]  J. Toouli,et al.  Minimal access surgery of the gastrointestinal tract. , 1995, The Australian and New Zealand journal of surgery.

[14]  M. Memon.  Review. Laparoscopic appendicectomy: current status. , 1997, Annals of the Royal College of Surgeons of England.

[15]  K. Georgeson,et al.  The learning curve associated with laparoscopic antireflux surgery in infants and children. , 1997, Journal of pediatric surgery.

[16]  S. Nakada,et al.  Use of the pneumo sleeve as an adjunct in laparoscopic nephrectomy. , 1997, Urology.

[17]  S. Stryker,et al.  The learning curve for laparoscopic colorectal surgery. Preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomies. , 1997, Archives of surgery.

[18]  S. Wexner,et al.  Laparoscopic bowel resection: advantages and limitations. , 1992, Annals of medicine.

[19]  B. Gaster.  A piece of my mind. The learning curve. , 1993, JAMA.

[20]  T. Gadacz,et al.  Complications of laparoscopic surgery. , 1993, The Surgical clinics of North America.

[21]  R. Fitzgibbons,et al.  Assessing risks, costs, and benefits of laparoscopic hernia repair. , 1998, Annual review of medicine.

[22]  R. Beart,et al.  Role of laparoscopy in colorectal surgery A prospective evaluation of 200 cases , 1995, Diseases of the colon and rectum.