We read with interest the article “Hand-assist laparoscopic surgery for the gynecologic surgeon” by Brothertonet al.[1] We agree with their conclusions that hand-assisted laparoscopy is underutilized in gynecology and pelvic surgery despite its potential benefits.However, we were surprised and disappointed by the authors’ failure to acknowledge our extensive seminal contributions on the use of hand-assisted laparoscopy in benign pelvic conditions and gynecologic cancer. All of our work has been published in peer review journals, and in 2004 we also contributed a book chapter on the use of hand-assisted laparoscopy in pelvic surgery.[2]The first contribution to the medical literature regarding the use of hand-assisted laparoscopy in gynecology was published by us in 1999.[3] That same year, we reported our experience with hand-assisted laparoscopic cholecystectomy for cesarean section.[4] In 2000, we reported for the first time the value of hand-assisted laparoscopy for the performance of megamyomectomy.[5]The authors quoted 4 papers related to the use of hand-assisted laparoscopy in gynecologic cancer while ignoring the first contribution to the literature on the subject published by us in 2000.[6] We were the first to report the value of the technique as an effective and safe method to facilitate the completion of complex oncologic procedures that may otherwise require a lengthy, difficult and risky conventional laparoscopic surgery or conversion to laparotomy. At the time–exactly one decade ago–we had already reported the value of hand-assisted laparoscopy in surgical staging and the value of the hand port to allow a simplified, uncontaminated, and rapid removal of an intact tumor, omentum, and lymph nodes. We also reported the simplicity of hand-assisted omentectomy and lymph node dissection.Brothertonet al[1] wrote, “The use of the intraperitoneal hand may provide a minimally invasive alternative for gynecological oncologists not comfortable in laparoscopic lymph node dissection.” The statement is quite similar to the one that we stated a decade ago, “Oncologic surgeons reluctant to adopt conventional laparoscopic surgery may find the hand-assisted approach an appealing minimally access modality.”Sincerely,