Laparoscopic total colectomy: hand-assisted vs standard technique

Surg Endosc. 2004 Apr;18(4):582-6. doi: 10.1007/s00464-003-8135-8. Epub 2004 Mar 19.

Abstract

Background: Although hand-assisted laparoscopic surgery (HALS) has been proposed as an alternative to laparoscopically assisted surgery (LAP), little is known about its role in total colectomy. The objectives of the study were to compare the outcomes in patients undergoing total colectomy via either HALS or LAP and to determine what benefits HALS might have in extensive colorectal procedures.

Methods: We reviewed the data for 23 patients who underwent total proctocolectomy (TPC) or total abdominal colectomy (TAC) using either a HALS or LAP technique.

Results: There were 12 HALS (five TPC, seven TAC) and 11 LAP (seven TPC, four TAC) for ulcerative colitis (n = 17), familial polyposis (n = 5), and colonic inertia (n = 1). One LAP was converted (9.1%). The operative time was shorter for HALS than for LAP (210 vs 273 min; p = 0.03). Blood loss and incision length were similar. Postoperative recovery and morbidity rates were comparable.

Conclusion: HALS reduces the operative time but patient morbidity rates and recovery are similar to LAP. HALS may be preferable for extensive colorectal procedures such as TPC and TAC.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Colectomy / methods*
  • Colectomy / statistics & numerical data
  • Colonic Diseases / surgery*
  • Colorectal Neoplasms / surgery*
  • Databases, Factual
  • Elective Surgical Procedures / statistics & numerical data
  • Female
  • Hand
  • Humans
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Proctocolectomy, Restorative / methods*
  • Proctocolectomy, Restorative / statistics & numerical data
  • Prospective Studies
  • Recovery of Function
  • Rectal Diseases / surgery*
  • Retrospective Studies
  • Treatment Outcome