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- Hand-Assisted Laparoscopic Surgery: A Versatile Tool for Colorectal Surgeons
- Ju Yong Cheong, Christopher J. Young
- Ann Coloproctol. 2017;33(4):125-129. Published online August 31, 2017
- DOI: https://doi.org/10.3393/ac.2017.33.4.125
- 6,451 View
- 65 Download
- 7 Web of Science
- 7 Citations
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Abstract
PDF Purpose Hand-assisted laparoscopic surgery (HALS) is a minimally invasive surgical technique with the combined benefits of laparoscopic surgery while allowing the use of the surgeon's hand for better tactile control. Obesity has been associated with higher conversion rates with multiport laparoscopic surgery, but not with HALS. This study aimed to examine the versatility of HALS in various clinical contexts.
Methods All HALSs performed at 2 major tertiary centers in Sydney were prospectively collected for retrospective analysis. Variables including age, sex, body mass index (BMI), previous surgeries, pathologies including size and T-stage, and the number of conversions to a midline laparotomy were examined.
Results A total of 121 HALS colorectal resections were analyzed. The median age of the patients was 62 years, with 63.6% being women. Seven patients required conversion to a midline laparotomy. Of the 121 patients, 50.2% were overweight or obese, and 52.9% had undergone previous abdominal/pelvic operations. However, neither obesity nor abdominal adhesions from previous operations were an indication for conversion to an open laparotomy in any of the 7 converted patients. The presence of intra-abdominal adhesions did not impact the operative time. HALS allowed access to the entire colon and rectum and allowed resection of the bladder, uterus, and ureter, when these organs were involved.
Conclusion HALS is a versatile, minimally invasive technique, which is independent of the patient's BMI, for performing a colorectal resection.
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Citations
Citations to this article as recorded by
- Hand-Assisted Laparoscopic Surgery (HALS) as an Alternative to Unplanned Laparoscopic Conversion to Open Surgery (LCOS) in Colectomies for Acute Diverticulitis
Satyam K. Ghodasara, Jana K. Elsawwah, Stephanie S. Hyon, Joseph S. Flanagan, Patricia B. Stopper, Rolando H. Rolandelli, Zoltan H. Nemeth
Surgical Innovation.2025; 32(3): 222. CrossRef - Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef - Hand-assisted Laparoscopic Surgery (HALS) as an Alternative to Laparoscopic Converted to Open Surgery (LCOS) in Proctectomy Patients
Stephanie S. Hyon, Jana K. Elsawwah, Rahul Narang, Patricia B. Stopper, Rolando H. Rolandelli, Zoltan H. Nemeth
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef - Usefulness of Hand-assisted Laparoscopic Restorative Proctocolectomy for Ulcerative Colitis in the Era of Laparoscopic Surgery - A Single-center Observational Study
Hideaki Kimura, Kenichiro Toritani, Itaru Endo
Journal of the Anus, Rectum and Colon.2024; 8(3): 228. CrossRef - A single centre audit: repeat pre‐operative colonoscopy
Michelle Zhiyun Chen, Hareshdeva Devan Nair, Apoorva Saboo, Sharon Chih Lin Lee, Xinchen Gu, Sheik Mohammad Azhar Auckloo, Sandeep Tamang, Sally Jiasi Chen, Ryan William Lowe, Neil Strugnell
ANZ Journal of Surgery.2022; 92(10): 2571. CrossRef - Application of Laparoscopy in Comprehensive Staging Operation of Ovarian Cancer Based on Electronic Medical Blockchain Technology
Limei Zhang, Xinrui Li, Yao Ning, Yufei Cai, Zhihan Lv
Journal of Healthcare Engineering.2021; 2021: 1. CrossRef - Need for Reappraisal of Hand-Assisted Laparoscopic Surgery for Colorectal Diseases in the Era of Desiring Small Incisions
Chang-Nam Kim
Annals of Coloproctology.2017; 33(4): 119. CrossRef
- Hand-Assisted Laparoscopic Surgery (HALS) as an Alternative to Unplanned Laparoscopic Conversion to Open Surgery (LCOS) in Colectomies for Acute Diverticulitis
- The Role of Hand-Assisted Laparoscopic Surgery in a Right Hemicolectomy for Right-Sided Colon Cancer
- Sung Uk Bae, Jin Seok Park, Young Jin Choi, Min Ku Lee, Byung Sun Cho, Yoon Jung Kang, Joo Seung Park, Chang Nam Kim
- Ann Coloproctol. 2014;30(1):11-17. Published online February 28, 2014
- DOI: https://doi.org/10.3393/ac.2014.30.1.11
- 7,402 View
- 47 Download
- 14 Web of Science
- 11 Citations
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Abstract
PDF
Purpose The purpose of this study is to evaluate the perioperative and long-term oncologic outcomes of hand-assisted laparoscopic surgery (HALS) and standard laparoscopic surgery (SLS) and assess the role of HALS in the management of right-sided colon cancer.
Methods The study group included 53 patients who underwent HALS and 45 patients who underwent SLS for right-sided colon cancer between April 2002 and December 2008.
Results The patients in each group were similar in age, American Society of Anesthesiologist (ASA) score, body mass index, and history of previous abdominal surgeries. Eight patients in the HALS group and no patient in the SLS group exhibited signs of tumor invasion into adjacent structures. No differences were noted in the time to return of normal bowel function, time to toleration of diet, lengths of hospital stay and narcotic usage, and rate of postoperative complications. The median incision length was longer in the HALS group (HALS: 7.0 cm vs. SLS: 4.8 cm, P < 0.001). The HALS group had a significantly higher pathologic TNM stage and significantly larger tumor size (HALS: 6.0 cm vs. SLS: 3.3 cm, P < 0.001). The 5-year overall, disease-free, and cancer-specific survival rates of the HALS and the SLS groups were 87.3%, 75.2%, and 93.9% and 86.4%, 78.0%, and 90.7%, respectively (P = 0.826, P = 0.574, and P = 0.826).
Conclusion Although patients in the HALS group had more advanced disease and underwent more complex procedures than those in the SLS group, the short-term benefits and the oncologic outcomes between the two groups were comparable. HALS can, therefore, be considered an alternative to SLS for bulky and fixed right-sided colon cancer.
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Citations
Citations to this article as recorded by- The terminal ileal vein approach: a novel and simple technique for locating the superior mesenteric vein and en bloc resection of the ileal mesentery in laparoscopic right hemicolectomy
Yi-Jun Liao, Si-Yuan Mi, Da Kang, Xin Tang, Gong Chen, Zhi-Zhong Pan, Rong-Xin Zhang
Updates in Surgery.2025; 77(8): 2311. CrossRef - Effect of postoperative complications on 5-year survival following laparoscopic surgery for resectable colorectal cancer: a retrospective study
Jae Eun Lee, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek, Sung Uk Bae
International Journal of Colorectal Disease.2024;[Epub] CrossRef - Right hemicolectomy: a network meta-analysis comparing open, laparoscopic-assisted, total laparoscopic, and robotic approach
Emanuele Rausa, Michael Eamon Kelly, Emanuele Asti, Alberto Aiolfi, Gianluca Bonitta, Luigi Bonavina
Surgical Endoscopy.2019; 33(4): 1020. CrossRef - Outcomes of open, laparoscopic, and hand-assisted laparoscopic surgeries in elderly patients with right colon cancers
Mingtian Wei, Xubing Zhang, Pingfan Ma, Wanbin He, Liang Bi, Ziqiang Wang
Medicine.2018; 97(35): e11907. CrossRef - Hand-assisted laparoscopic right hemicolectomy with complete mesocolic excision and central vascular ligation: a novel technique for right colon cancer
Qing-Bin Wu, Xiang-Bing Deng, Xu-Yang Yang, Bing-Chen Chen, Wan-Bin He, Tao Hu, Ming-Tian Wei, Zi-Qiang Wang
Surgical Endoscopy.2017; 31(8): 3383. CrossRef - Hand-assisted laparoscopic surgery versus laparoscopic right colectomy: a meta-analysis
Guosen Wang, Jianping Zhou, Weiwei Sheng, Ming Dong
World Journal of Surgical Oncology.2017;[Epub] CrossRef - Robotic Complete Mesocolic Excision and Intracorporeal Anastomosis Using a Robotic Stapler for Right-Sided Colon Cancer With Reduced-Port Access
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Diseases of the Colon & Rectum.2017; 60(4): 456. CrossRef - Advances in Laparoscopic Colorectal Surgery
James Michael Parker, Timothy F. Feldmann, Kyle G. Cologne
Surgical Clinics of North America.2017; 97(3): 547. CrossRef - Need for Reappraisal of Hand-Assisted Laparoscopic Surgery for Colorectal Diseases in the Era of Desiring Small Incisions
Chang-Nam Kim
Annals of Coloproctology.2017; 33(4): 119. CrossRef - Hand-Assisted Laparoscopic Surgery Versus Conventional Laparoscopic Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis
Xubing Zhang, Qingbin Wu, Tao Hu, Chaoyang Gu, Liang Bi, Ziqiang Wang
Journal of Laparoendoscopic & Advanced Surgical Techniques.2017; 27(12): 1251. CrossRef - Hand-Assisted Laparoscopic Right Colectomy: Is It Useful?
Hungdai Kim
Annals of Coloproctology.2014; 30(1): 1. CrossRef
- The terminal ileal vein approach: a novel and simple technique for locating the superior mesenteric vein and en bloc resection of the ileal mesentery in laparoscopic right hemicolectomy
- Clinical Outcomes of 103 Hand-Assisted Laparoscopic Surgeries for Left-Sided Colon and Rectal Cancer: Single Institutional Review
- Narimantas Evaldas Samalavicius, Rakesh Kumar Gupta, Audrius Dulskas, Darius Kazanavicius, Kestutis Petrulis, Raimundas Lunevicius
- Ann Coloproctol. 2013;29(6):225-230. Published online December 31, 2013
- DOI: https://doi.org/10.3393/ac.2013.29.6.225
- 5,976 View
- 40 Download
- 13 Citations
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Abstract
PDF
Purpose The laparoscopic colectomy is avoided principally because of its technical difficulty, steep learning curve, and increased operative time. Hand-assisted laparoscopic surgery (HALS) is an alternative technique that addresses these problems while preserving the short-term benefits of a laparoscopic colectomy. Our study was aimed to describe the characteristics of patients admitted due to left-sided colon and rectal cancer for HALS.
Methods A prospectively maintained database was used to identify patients who underwent HALS at the Institute of Oncology, Vilnius University, from July 1, 2009, to October 1, 2012.
Results One hundred-three HALS colorectal resections were performed. The patients' mean age was 64 ± 13.4 years. There were 46 male and 57 female patients. The body mass index was 27.3 ± 5.8 kg/m2. Forty-three patients (41.8%) had experienced prior abdominal surgery. The mean HALS time was 105 minutes (range, 55-85 minutes). The conversion rate was 2.7% (3/103). The median of return of gastrointestinal function was 2.5 days (range, 2.2-4.5 days). The median length of hospital stay was 9 days. The postoperative complication and mortality rates were 10.7% and 0.97%, respectively. Four incisional hernias (3.9%) were seen at a mean follow-up of 7.0 ± 3.4 months. None of the patients had a trocar or a hand-port site recurrence.
Conclusion A HALS colorectal resection is a safe and effective technique, and it provides all the benefits of minimally invasive surgery.
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Citations
Citations to this article as recorded by- Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef - Hand Assisted Laparoscopic Surgery for Colorectal Cancer: Surgical and Oncological Outcomes from a Single Tertiary Referral Centre
Narimantas Evaldas Samalavicius, Zygimantas Kuliesius, Robertas Stasys Samalavičius, Renatas Tikuisis, Edgaras Smolskas, Zilvinas Gricius, Povilas Kavaliauskas, Audrius Dulskas
Journal of Clinical Medicine.2022; 11(13): 3781. CrossRef - Laparoscopic and Robotic Surgery for Rectal Cancer—Comparative Study Between Two Centres
Audrius Dulskas, Mahdi Albandar, Narimantas E. Samalavicius, Yoon Dae Han, Nam Kyu Kim
Indian Journal of Surgery.2021; 83(1): 48. CrossRef - Laparoscopic hand‐assisted total mesorectal excision for mid rectal cancer using the Gelport system—a video vignette
Narimantas E. Samalavicius, Vita Klimasauskiene, Audrius Dulskas
Colorectal Disease.2021; 23(4): 1018. CrossRef - Hand‐assisted laparoscopic surgery for rectal cancer – a video vignette
N. E. Samalavicius, P. Kavaliauskas, A. Dulskas
Colorectal Disease.2019; 21(11): 1336. CrossRef - High vascular ligation in left-sided colon cancer surgery is safe and adequate
Narimantas E. Samalavicius, Audrius Dulskas, Simonas Uselis, Edgaras Smolskas, Giedre Smailyte, Raimundas Lunevicius
European Surgery.2018; 50(5): 221. CrossRef - Laparoscopic colectomy in obese patients: a comparison of laparoscopic and hand-assisted laparoscopic techniques
Douglas M. Overbey, Michelle L. Cowan, Patrick W. Hosokawa, Brandon C. Chapman, Jon D. Vogel
Surgical Endoscopy.2017; 31(10): 3912. CrossRef - HAND-ASSISTED LAPAROSCOPIC SURGERY FOR THE CANCER OF THE LEFT COLON AND RECTUM - AN IDEAL OPTION OF MINIMALLY INVASIVE SURGERY? SINGLE CENTRE EXPERIENCE WITH 459 CASES
Narimantas E. Samalavicius, Zygimantas Kuliesius, Audrius Dulskas, Justas Kuliavas, Giedre Rudinskaite, Edgaras Smolskas, Afredas Kilius, Kestutis Petrulis
Koloproktologia.2017; (4): 7. CrossRef - Is There Still a Role for Video-Assisted Laparoscopic Gastric Banding in Severe Obesity?
Nicola Zampieri, Roberto Castellani, Lorenzo Francia
Bariatric Surgical Practice and Patient Care.2016; 11(1): 25. CrossRef - Laparoscopic sigmoid colectomy: Are all laparoscopic techniques created equal?
Emily F. Midura, Dennis J. Hanseman, Bradley R. Davis, Bobby L. Johnson, Joshua W. Kuethe, Janice F. Rafferty, Ian M. Paquette
Surgical Endoscopy.2016; 30(8): 3567. CrossRef - Preoperative prediction of conversion from laparoscopic rectal resection to open surgery: a clinical study of conversion scoring of laparoscopic rectal resection to open surgery
Guang-Dong Zhang, Xu-Ting Zhi, Jian-Li Zhang, Guang-Bo Bu, Gang Ma, Kai-Lei Wang
International Journal of Colorectal Disease.2015; 30(9): 1209. CrossRef - Hand-Assisted Laparoscopic Approach in Colon Surgery
Zhobin Moghadamyeghaneh, Joseph C. Carmichael, Steven Mills, Alessio Pigazzi, Ninh T. Nguyen, Michael J. Stamos
Journal of Gastrointestinal Surgery.2015; 19(11): 2045. CrossRef - What Is the Role of Hand-Assisted Laparoscopic Surgery in the Single-Port Surgery Era?
Chang-Nam Kim
Annals of Coloproctology.2013; 29(6): 217. CrossRef
- Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
- Short-term Outcomes of Hand-Assisted Laparoscopic Surgery vs. Open Surgery on Right Colon Cancer: A Case-Controlled Study
- Jae-Hoon Sim, Eun-Joo Jung, Chun-Geun Ryu, Jin Hee Paik, Gangmi Kim, Su Ran Kim, Dae-Yong Hwang
- Ann Coloproctol. 2013;29(2):72-76. Published online April 30, 2013
- DOI: https://doi.org/10.3393/ac.2013.29.2.72
- 10,359 View
- 46 Download
- 14 Citations
-
Abstract
PDF
Purpose This study was designed to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery with open surgery for right colon cancer.
Methods Sixteen patients who underwent a hand-assisted laparoscopic right hemicolectomy (HAL-RHC group) and 33 patients who underwent a conventional open right hemicolectomy (open group) during the same period were enrolled in this study with a case-controlled design.
Results The operation time was 217 minutes in the HAL-RHC group and 213 minutes in the open group (P = 0.389). The numbers of retrieved lymph nodes were similar between the two groups (31 in the HAL-RHC group and 36 in the open group, P = 0.737). Also, there were no significant difference in the incidence of immediate postoperative leukocytosis, the administration of additional pain killers, and the postoperative recovery parameters. First flatus was shown on postoperative days 3.5 in the HAL-RHC group and 3.4 in the open group (P = 0.486). Drinking water and soft diet were started on postoperative days 4.8 and 5.9, respectively, in the HAL-RHC group and similarly 4.6 and 5.6 in the open group (P = 0.402 and P = 0.551). The duration of hospital stay was shorter in the HAL-RHC group than in the open group (10.3 days vs. 13.5 days, P = 0.048). No significant difference in the complication rates was shown between the two groups, and no postoperative mortality was encountered in either group.
Conclusion The patients with right colon cancer in the HAL-RHC group had similar pathologic and postoperative recovery parameters to those of the patients in the open group. The patients in the HAL-RHC group had shorter hospital stays than those in the open group. Therefore, hand-assisted laparoscopic right hemicolectomy for right-sided colon cancer is feasible.
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Citations
Citations to this article as recorded by- Evaluating the learning curves and surgical outcomes of natural orifice specimen extraction surgery (NOSES) for colorectal cancer: A retrospective analysis from a National Registry
Yunxiao Liu, Xu Guan, Qing Xu, Taiyuan Li, Yangchun Zheng, Chuangang Fu, Sergey Efetov, Xishan Wang, Guiyu Wang
Colorectal Disease.2025;[Epub] CrossRef - Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2021; 37(6): 434. CrossRef - A meta-analysis comparing hand-assisted laparoscopic right hemicolectomy and open right hemicolectomy for right-sided colon cancer
Mohamed Ali Chaouch, Mohamed Wejih Dougaz, Meriem Mesbehi, Hichem Jerraya, Ramzi Nouira, Jim S. Khan, Chadli Dziri
World Journal of Surgical Oncology.2020;[Epub] CrossRef - Laparoscopic right-sided colon resection for colon cancer—has the control group so far been chosen correctly?
Jörg O. W. Pelz, Johanna Wagner, Sven Lichthardt, Johannes Baur, Caroline Kastner, Niels Matthes, Christoph-Thomas Germer, Armin Wiegering
World Journal of Surgical Oncology.2018;[Epub] CrossRef - Hand-assisted Laparoscopy: Expensive but Considerable Step Between Laparoscopic and Open Colectomy
Baris Gulcu, Ozgen Isik, Ersin Ozturk, Tuncay Yilmazlar
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2018; 28(4): 214. CrossRef - Hand-assisted laparoscopic surgery versus conventional open surgery in intraoperative and postoperative outcomes for colorectal cancer
Xubing Zhang, Qingbin Wu, Chaoyang Gu, Tao Hu, Liang Bi, Ziqiang Wang
Medicine.2017; 96(33): e7794. CrossRef - Comparison of hand-assisted laparoscopic surgery (HALS) and conventional laparotomy in patients with colorectal cancer: Final results from a single center
Takayuki Tajima, Masaya Mukai, Daiki Yokoyama, Shigeo Higami, Shuji Uda, Sayuri Hasegawa, Eiji Nomura, Sotaro Sadahiro, Seiei Yasuda, Hiroyasu Makuuchi
Oncology Letters.2017; 13(6): 4953. CrossRef - Hand‐assisted laparoscopic colorectal surgery with double‐glove technique
Hernán Vaccarezza, Axel Sahovaler, Víctor Im, Gustavo Rossi, Carlos Vaccaro
Surgical Practice.2016; 20(3): 124. CrossRef - Laparoscopic resection of right colon cancer—a matched pairs analysis
M. Zimmermann, C. Benecke, C. Jung, M. Hoffmann, J. Nolde, E. Schlöricke, H. P. Bruch, T. Keck, T. Laubert
International Journal of Colorectal Disease.2016; 31(7): 1291. CrossRef - Comparative Study on Therapeutic Efficacy Between Hand-Assisted Laparoscopic Surgery and Conventional Laparotomy for Acute Obstructive Right-Sided Colon Cancer
Zhengrong Li, Daojiang Li, Zhigang Jie, Guoyang Zhang, Yi Liu
Journal of Laparoendoscopic & Advanced Surgical Techniques.2015; 25(7): 548. CrossRef - Comparison of hand-assisted laparoscopic surgery and conventional laparotomy for rectal cancer: Interim results from a single center
TAKAYUKI TAJIMA, MASAYA MUKAI, WATARU NOGUCHI, SHIGEO HIGAMI, SHUUJI UDA, SOUICHIROU YAMAMOTO, SAYURI HASEGAWA, EIJI NOMURA, SOTARO SADAHIRO, SEIEI YASUDA, HIROYASU MAKUUCHI
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JiaQing Gong, YongKuan Cao, YunMing Li, GuoHu Zhang, PeiHong Wang, GuoDe Luo
Surgical Endoscopy.2014; 28(10): 2998. CrossRef - Comparison of hand-assisted laparoscopic surgery and conventional laparotomy for colorectal cancer: Interim results from a single institution
TAKAYUKI TAJIMA, MASAYA MUKAI, MASASHI YAMAZAKI, SHIGEO HIGAMI, SOUICHIROU YAMAMOTO, SAYURI HASEGAWA, EIJI NOMURA, SOTARO SADAHIRO, SEIEI YASUDA, HIROYASU MAKUUCHI
Oncology Letters.2014; 8(2): 627. CrossRef - Should Hand-Assisted Laparoscopic Surgery Be Placed in the Realm of Minimally Invasive Surgery?
Hungdai Kim
Annals of Coloproctology.2013; 29(2): 42. CrossRef
- Evaluating the learning curves and surgical outcomes of natural orifice specimen extraction surgery (NOSES) for colorectal cancer: A retrospective analysis from a National Registry
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