REVIEWS   

Minerva Chirurgica 2008 October;63(5):373-83

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Hand-assisted laparoscopic colorectal surgery: an evidence-based review

Martel G. ¹, Boushey R. P. ¹, Marcello P. W. ²

¹ Division of General Surgery Colon and Rectal Surgery Unit The Ottawa Hospital University of Ottawa, ON, Canada 2 Department of Colon and Rectal Surgery Lahey Clinic, Burlington, MA, USA

Despite its increasing use by practitioners, laparoscopic colorectal surgery remains technically challenging. Hand-assisted laparoscopic colorectal surgery may represent a viable hybrid alternative approach to standard laparoscopy. Although few high-quality studies have been carried out, hand-assistance appears to reduce operative time when compared to straight laparoscopy for both left-sided segmental colonic and total colorectal resections. Moreover, hand-assistance appears to maintain the short-term benefits of laparoscopy, while affording the surgeon with the ability to carry out complex cases in a minimally invasive fashion. Data pertaining to the use of hand-assistance for rectal cancer surgery are currently lacking. One the whole, hand-assisted laparoscopic colorectal surgery appears to be a useful tool for the minimally invasive surgeon, one that is perhaps best thought of as an adjunct to simple laparoscopy.