Terrazas EF, Galindo NA, Ruiz PC, Carrera MA, Martínez MJJ

Language: Spanish
References: 25
Page: 39-45
PDF size: 199.83 Kb.

ABSTRACT

Objective: To report the experience in hand-assisted laparoscopic surgery as an additional resource to laparoscopic surgery of the colon.
Setting: Hospital Español. (Third level health care hospital.)
Design: Prospective, descriptive case series study.
Statistical analysis: Central tendency measures, percentages as summary measure for qualitative variables.
Material and methods: Report on 22 patients operated with hand-assisted laparoscopic surgery performed from March 2006 to January 2009. We assessed the type of performed surgery, surgical time, conversion, size of the surgical wound for hand introduction, number of trocars, trans- and post-operative morbidity, length of hospital stay, and mortality.
Results: Right hemicolectomy with anastomosis was performed in six patients, sigmoid resection in nine patients, colostomy in three patients, and anastomosis in the remainder patients. Restitution of the intestinal transit of the left colon was performed in three patients with previous colostomy, and left hemicolectomy with anastomosis in four patients. Average surgical time was of 177.5 min (85 - 220 min), without any conversion, the average size of the surgical wounds was 7.3 cm (7-9 cm). No trans-operative complication occurred. An anastomosis leak occurred on the 7^th day after surgery; average length of hospital stay was 7.6 days (6 - 10 days). No deaths occurred.
Conclusions: We consider that the hand-assisted laparoscopic surgery is a useful resource for laparoscopic surgery of the colon, as it eases dissection, and should not be considered as opposed to pure laparoscopic surgery.

REFERENCES

1. Ballantyne GH, Leahy PF. Hand-assisted laparoscopic colectomy: evolution to a clinically usefull technique. Dis Colon Rectum 2004; 47: 753-65.

2. Ou H. Laparoscopic-assisted mini laparotomy with colectomy. Dis Colon Rectum 1995; 38: 324-26.

3. Neto JAP, Lacombe D. Video-assisted manual surgery. En: Wexner SD (ed). Laparoscopic Colorectal Surgery. New York, Wiley-Liss, 1999: 307-22.

4. Bergamaschi R, Tuetch JJ, Pessaux P, Arnaud JP. Intracorporeal vs laparoscopic-assisted resection for uncomplicated diverticulitis of the sigmoid. Surg Endosc 2000; 14: 520-523.

5. Rivadeneira DE, Marcello PW, Roberts PL, Rusin LC, Murray JJ, Coller JA, et al. Benefits of hand-assisted laparoscopic restorative proctocolectomy: a comparative study. Dis Colon Rectum 2004; 47: 1371-1376.

6. Chang YJ, Marcello PW, Rusin LC, Roberts PL, Schoetz DJ. Hand-assisted laparoscopic sigmoid colectomy: helping hand or hindrance? Surg Endosc 2005; 19: 656-61.

7. Kang JC, Chung MH, Chao PC, Yeh CC, Hsiao CW, Lee TY, et al. Hand-assisted laparoscopic colectomy vs open colectomy: a prospective randomized study. Surg Endosc 2004; 18: 577-81.

8. Dai LH, Xu B, Zhu GH. Hand-assisted laparoscopic surgery of abdominal large visceral organs. World J Gastroenterol 2006; 12: 4736-40.

9. Schadde E, Smith D, Alkoraishi AS, Begos DG. Hand-assisted laparoscopic colorectal surgery (HALS) at a community hospital: a prospective analysis of 104 consecutive cases. Surg Endosc 2006; 20: 1077-82.

10. Wilhelm TJ, Refeidi A, Palma P, Neufang T, Post S. Hand-assisted laparoscopic sigmoid resection for diverticular disease:100 consecutive cases. Surg Endosc 2006; 20: 477-81.

11. Memon MA, Fitzgibbons RJ. Hand-assisted laparoscopic surgery for colorectal malignancies. J Coll Physicians Surg Pak 2004; 14: 566-9.

12. Cobbs WS, Lokey JS, Schwab DP, Crockett JA, Rex JC, Robbins JA. Hand-assisted laparosopic colectomy: a single-institution experience. Am Surg 2003; 69: 578-80.

13. Wu J, Shao Y, Rong W, Wang X, Zhao D, Wang J, Bi J, et al. [Hand-assisted laparoscopic surgery in colorectal carcinoma resection: a report of 14 cases] [artículo en Chino]. Zhonghua Zhong Liu Za Zhi 2002; 24: 599-601.

14. Targarona EM, Gracia E, Garriga J, Martinez-Bru C, Cortés M, Boluda R, et al. Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy: applicability, immediate clinical outcome, inflammatory response, and cost. Surg Endosc 2002; 16: 234-39.

15. Anderson J, Luchtefeld M, Dujovny N, Hoedema R, Kim D, Butcher J. A comparison of laparoscopic, hand-assist and open sigmoid resection in the treatment of diverticular disease. Am J Surg 2007; 193: 400-403.

16. Nakajima K, Lee SW, Cocilovo C, Foglia C, Sonoda T, Milsom JW. Laparoscopic total colectomy: hand-assisted vs standard technique. Surg Endosc 2004; 18: 582-86.

17. Lee SW, Yoo J, Dujovny N, Sonoda T, Milsom JW. Laparoscopic vs hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 2006; 49: 464-69.

18. Litwin DE, Darzi A, Jakimowicz J, Kelly JJ, Arvidsson D, Hansen P, et al. Hand-assisted Laparoscopic Surgery (HALS) with the HandPort system, initial experience with 68 patients. Ann Surg 2000; 231: 715-23.

19. Chen W, Sailhamer E, Berger DL, Rattner DW. Operative time is a poor surrogate for the learning curve in laparoscopic colorectal surgery. Surg Endosc 2007; 21: 238-43.

20. Kang JC, Jao SW, Chung MH, Feng CC, Chang YJ. The learning curve for hand-assisted laparoscopic colectomy: a single surgeon´s experience. Surg Endosc 2007; 21: 234-37.

21. Targarona EM, Gracia E, Rodriguez M, Cerdán G, Balagué C, Garriga J, et al. Hand-assisted laparoscopic surgery. Arch Surg 2003; 138: 133-41.

22. Kaban GK, Czerniach DR, Litwin DE, Litwin DE. Hand-assisted laparoscopic surgery. Surg Technol Int 2003; 11: 63-70.

23. Southern Surgeons´ Club Study Group. Handoscopic surgery: a prospective multicenter trial of a minimally invasive technique for complex abdominal surgery. Arch Surg 1999; 134: 477-485.

24. Hanna GB, Elamass M, Cuschieri A. Ergonomics of hand-assisted laparoscopic surgery. Semin Laparosc Surg 2001; 8: 92-95.

25. Montgomery JS, Johnston WK 3rd, Wolf JS Jr. Wound complications after hand assisted laparoscopic surgery. J Urol 2005; 174: 2226-30.