No abstract available.
Hand-Assisted Laparoscopy*

No abstract available.
Hand-Assisted Laparoscopy*

No abstract available.
Emergencies* ; Hand-Assisted Laparoscopy*

No abstract available.
Hand-Assisted Laparoscopy

OBJECTIVETo compare the effects of hand-assisted laparoscopic and traditional laparoscopic right hemicolectomy on immune function.

METHODSFrom May 2010 to November 2013, 60 patients with right colon carcinoma were prospectively enrolled and randomly divided into hand-assisted laparoscopic surgery(HALS) group and traditional laparoscopic surgery(TLS) group with 30 cases in each group. CRP, IL-6, CD3+, CD4+, CD8+ in the peripheral blood were measured and compared on the first day before operation, the first, third and fifth day after operation.

RESULTSCRP and IL-6 levels in two groups were significantly increased on the first, third and fifth days(P<0.01), and peaked on the third day after operation. Postoperative CRP and IL-6 levels were slightly higher in HALS group, but the difference was not statistically significant (P>0.05). CD3+ and CD4+ levels were significantly decreased on the first, third day after operation(P<0.05), and returned to preoperative levels on the fifth day after operation in both two groups, and the difference was not statistically significant(P>0.05). There was no significant difference in CD8+ between two groups either before surgery or after operation(P>0.05).

CONCLUSIONHand-assisted laparoscopic right hemicolectomy has the same effects of traditional laparoscopic right hemicolectomy in the relief of postoperative stress and the protection of immune function.

Despite gaining wider popularity in the management of both benign and malignant gastrointestinal diseases over the past decade, traditional laparoscopic surgery remains to be associated with several distinct disadvantages, including longer operative time, longer learning curve, technical difficulty in obese patients and complicated cases. As a hybrid technique between open surgery and traditional laparoscopic surgery, hand-assisted laparoscopic surgery (HALS) brings back tactile feeling and hand-to-eye coordination to surgeons. It allows surgeons to perform more complicated gastrointestinal surgery, while retaining the merits of traditional laparoscopic surgery. It also improves operative time and learning curve. The main disadvantages of HALS seem to be the hindering effect and fatigue of the inserted hand. The exact role of HALS in gastrointestinal surgery has not been well defined due to lack of substantial evidences from clinical trials.
Digestive System Surgical Procedures ; Hand-Assisted Laparoscopy ; Humans

OBJECTIVETo study the feasibility of hand-assisted laparoscopic radical resection of rectal carcinoma and compare the short-term outcomes of HALS versus traditional laparoscopy approach.

METHODSClinical data of 42 cases of rectal carcinoma between January 2010 and March 2011 were enrolled in this study. Nineteen cases underwent HALS total mesorectal excision and 23 cases underwent traditional laparoscopy approach.

RESULTSAll the operations were successfully accomplished without conversions to open surgery. The mean operation time of the HALS group was shorter than that of the traditional laparoscopic group (152 min vs. 168 min, P=0.009). Incision length was significantly longer in the HALS group (5.6 cm vs. 4.5 cm, P=0.000). The median overall costs were lower in HALS group (26 000 RMB vs. 29 000 RMB, P=0.008). The number of lymph nodes in resected specimen, intra-operative blood loss, length of hospital stay, time to passage of flatus were comparable between the two groups.

CONCLUSIONSHand-assisted laparoscopic surgery has the advantages of laparoscopic surgery including minimal invasiveness, safety, and quicker postoperative recovery.

We performed hand-assisted laparoscopic surgery for a 67-year-old male with a 5.6 cm sized abdominal aortic aneurysm. To the best of our knowledge, this is the first report in Korea. After an initial hand dissection of the abdominal aorta under laparoscopy, we performed proximal anastomosis and distal abdominal aorta suture ligation through a 6 cm abdominal incision. Distal anastomosis was done at the bilateral common femoral arteries. He resumed his oral intake 6 hours after the surgery and discharged at the 4th postoperative day.
Aged ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Femoral Artery ; Hand ; Hand-Assisted Laparoscopy ; Humans ; Korea ; Laparoscopy ; Ligation ; Male ; Sutures

PURPOSE: We retrospectively compared our initial experience with the hand-assisted laparoscopic and retroperitoneoscopic radical nephrectomy for suspected renal cell carcinoma MATERIALS AND METHODS: We reviewed 26 hand-assisted laparoscopic and 9 retroperitoneoscopic radical nephrectomies performed for suspected renal cell carcinoma from December 1999 to January 2003. All data were collected from medical records and by personal contacts. RESULTS: Although days of oral intake was shorter in the retroperitoneoscopic radical nephrectomy than the hand-assisted laparoscopic radical nephrectomy(1.8 versus 2.3, p=0.027), the mean operative time, analgesics use, and postoperative stay for retroperitoneal group were not significantly different from the values of the hand-assisted group. CONCLUSIONS: Retroperitoneoscopic radical nephrectomy offers shorter days of oral intake comparable to that of hand-assisted laparoscopy. However, no significant differences in operative time, analgesics use, and postoperative stay were noted. Therefore, we believe that both techniques produce similar surgical results. Further randomized studies are needed.
Analgesics ; Carcinoma, Renal Cell ; Hand ; Hand-Assisted Laparoscopy ; Humans ; Laparoscopy ; Medical Records ; Nephrectomy* ; Operative Time ; Retroperitoneal Space ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the feasibility and potential benefits of Hand-Assisted Laparoscopic Surgery (HALS) with the HandPort system. The surgeon inserts the nondominant hand into the abdomen while the pneumoperitoneum is maintained. The hand assists laparoscopic instruments and is helpful in complex laparoscopic surgery. This approach provides an excellent means to explore, to retract safely, and to apply immediate hemostasis when needed. METHODS: A prospective study was performed in patients who had undergone surgical intervention with the HandPort system at Ewha Womans University Mok-Dong Hospital. The surgeon was free to test the device in any situation where they expected a potential advantage over conventional laparoscopy. The surgeon inserted the nondominant hand into the abdomen while the pneumoperitoneum was generally maintained at 13 mmHg. RESULTS: Thirteen patients were entered in the study. Operations included radical gastrectomy in 8 cases, subtotal gastrectomy in 1 case, hemicolecotmy in 2, distal pancreatectomy with splenectomy in 1, nephrectomy with splenectomy in 1. The mean incision size for the HandPort device was 7.5 cm for the nondominant hand. None of the patients required conversion to open surgery as a result of an unmanageable air leak. There were no postoperative problems and no cases of mortality. CONCLUSION: HALS with the HandPort system is helpful in complex laparoscopic surgery and appeared to be useful in minimally invasive procedures considered too complex for,a laparoscopic approach.
Abdomen ; Conversion to Open Surgery ; Female ; Gastrectomy ; Hand ; Hand-Assisted Laparoscopy* ; Hemostasis ; Humans ; Laparoscopy ; Mortality ; Nephrectomy ; Pancreatectomy ; Pneumoperitoneum ; Prospective Studies ; Splenectomy