Hand-assisted laparoscopic splenectomy.

Hand-assisted laparoscopic surgery (HALS) permits recovery of the tactile sensation and facilitates manipulation of solid organs. Our preliminary experience in laparoscopic splenectomy (LS) shows its advantages, with a substantial reduction of operative time, while maintaining the advantages of a less aggressive surgical approach. The role of HALS in cases of splenomegaly or trauma seems to be clear. It can also be considered as an alternative to conventional conversion in cases of intraoperative complications or unclear anatomy. The role of HALS for normal-sized spleens is more controversial because there is a well-systematized, conventional LS technique available, which is followed by optimal clinical outcome LS in hands of a skilled surgeon. Copyright 2001 by W.B. Saunders Company.