Li-Hua Dai1, Bo Xu, Guang-Hui Zhu. 1. Department of Surgery, The First Hospital of Guangzhou,1 Panfu Road, Guangzhou 510180, Guangdong Province, China. stswhz@zsu.edu.cn
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 h. 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.
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 h. 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.
Authors: D E Litwin; A Darzi; J Jakimowicz; J J Kelly; D Arvidsson; P Hansen; M P Callery; R Denis; D L Fowler; D S Medich; M J O'Reilly; H Atlas; J M Himpens; L L Swanstrom; E J Arous; P Pattyn; S M Yood; R Ricciardi; A Sandor; W C Meyers Journal: Ann Surg Date: 2000-05 Impact factor: 12.969
Authors: Abdulmalik M S Altaf; James Ellsmere; Hendrik Jaap Bonjer; Tarek H El-Ghazaly; Dennis R Klassen Journal: Can J Surg Date: 2012-08 Impact factor: 2.089