Hand-assisted laparoscopic colorectal surgery with double-glove technique

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Abstract

Aim:

The hand-assisted laparoscopic colorectal surgery (HALS) preserves the advantages of the minimally-invasive approach. However, its application has faced resistance due to the need of hand port devices and its increased costs. The aim of the present study was to assess the feasibility of an original technique using a double glove to keep pneumoperitoneum.

Patients and methods:

All patients operated with the HALS approach between 2004 and 2011 were analysed. Intraoperative and postoperative variables were also analysed. All procedures were performed with a double-glove technique to preserve the pneumoperitoneum.

Results:

There were 217 patients included in the present study (52 per cent males, mean age of 71 years and mean body mass index of 26.5 kg/m2). The median operating time was 150 min. The mean port number used was three, with a mean wound size of 5.25 cm. The conversion rate was 6 per cent, and the morbidity rate was 8.7 per cent with no postoperative deaths. The median hospital stay was 3 days. Mean harvested nodes were 16 (95 per cent confidence interval: 15–17). The readmission and reoperation rates were 2.3 per cent and 0.9 per cent, respectively.

Conclusion:

The double-glove hand-assisted laparoscopic technique represents a feasible option with good postoperative outcomes. Additionally, it represents a good cost-effective alternative.

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