Hand-Assisted Laparoscopic Surgery (HALS): A Useful Technique for Complex Laparoscopic Abdominal Procedures

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Abstract
Advanced laparoscopic abdominal surgery is now being performed routinely. However, it can be extremely challenging and time-consuming, and it may be associated with increased intraoperative and postoperative complications, mainly due to the loss of tactile sensation with totally laparoscopic techniques. This article describes a technique of hand-assisted laparoscopic surgery for complex abdominal procedures that allows the surgeon to insert a nondominant hand into the abdominal cavity while preserving the pneumoperitoneum. Use of the hand allows for rapid exploration, methodical dissection, identification of crucial structures, and expeditious performance of a procedure because of the maintenance of the tactile sensation. Our experience with this approach has been favorable.
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