Laparoscopic-Assisted Surgery.

Laparoscopy has changed our approach to surgery, instrumentation, and training. Remote control surgery with robotics and telematics is a future possibility. Laparoscopic surgery still has limitations not least the manual assessment of fixity and extraction of tumors with concern for oncological efficacy and port-site seeding of cancer. We report an Intromit (Medtech Ltd, Dublin, Ireland) hand-access device, allowing insertion of a hand and instruments while maintaining pneumoperitoneum. It has been used for splenectomy, colectomy, adhesiolysis, rectopexy, and fundoplication. It is hoped that this will facilitate laparoscopic cancer surgery, encourage surgeons to develop and engage in more advanced laparoscopic cancer procedures, and maintain many of the advantages of laparoscopic surgery including cost benefits.