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World J Gastroenterol. Aug 7, 2006; 12(29): 4736-4740
Published online Aug 7, 2006. doi: 10.3748/wjg.v12.i29.4736
Hand-assisted laparoscopic surgery of abdominal large visceral organs
Li-Hua Dai, Bo Xu, Guang-Hui Zhu
Li-Hua Dai, Bo Xu, Guanghui Zhu, Department of Surgery, The First Hospital of Guangzhou, Guangzhou 510180, Guangdong Province, China
Correspondence to: Li-Hua Dai, Department of Surgery, The First Hospital of Guangzhou,1 Panfu Road, Guangzhou 510180, Guangdong Province, China. stswhz@zsu.edu.cn
Telephone: +86-20-81048282 Fax: +86-20-84036493
Received: November 22, 2005
Revised: November 28, 2005
Accepted: February 18, 2006
Published online: August 7, 2006
Abstract

AIM: To design a hand-assisted laparoscopic approach in an attempt to provide an option for laparoscopic resection of abdominal large viscera.

METHODS: A 5-6 cm incision (for HandPort) and 2 trocars were employed. The main vessel of the target organ was taken as a “core”, and all tissues around the core were taken as peripheral structures. The peripheral structures were dissected first, and the core vessels were treated last. Twenty-six patients underwent laparoscopic deroofing of the hepatic huge cysts, resection of the segments lying at the outer edge of the liver (segments 2 to 6), splenectomy, hemicolectomy, ileocecectomy and subtotal gastrectomy with HandPort device, harmonic scalpel, or Ligasure.

RESULTS: The duration of the procedure was within 2 hours. Blood loss amounted to 8-120 mL. The conversion rate was 3.8% (1/26). All patients had uneventful postoperative courses with less pain, earlier oral intake, and faster recovery, compared with conventional surgery.

CONCLUSION: This method combines the advantages of both open and laparoscopic techniques, achieving better hemostasis effect, shortening the operative time, and is beneficial to the patients.

Keywords: Minimally invasive surgery; Hand-assisted laparoscopic surgery; Hepatic segmentectomy; Hemicolectomy; Subtotal gastrectomy