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The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease

OBJECTIVE: Hand assist laparoscopic surgery (HALS) is a surgical modality rarely used in benign gynecology. We analyzed nonmalignant pelvic disorders that utilized HALS to see whether there is any benefit over standard laparotomy. METHODS: A case control chart review identified patients who underwen...

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Autores principales: Brotherton, Joy, McCarus, Steven, Jones, Kathy Y., Redan, Jay, Kim, John C.
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021293/
https://www.ncbi.nlm.nih.gov/pubmed/20529531
http://dx.doi.org/10.4293/108680810X12674612014941
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author Brotherton, Joy
McCarus, Steven
Jones, Kathy Y.
Redan, Jay
Kim, John C.
author_facet Brotherton, Joy
McCarus, Steven
Jones, Kathy Y.
Redan, Jay
Kim, John C.
author_sort Brotherton, Joy
collection PubMed
description OBJECTIVE: Hand assist laparoscopic surgery (HALS) is a surgical modality rarely used in benign gynecology. We analyzed nonmalignant pelvic disorders that utilized HALS to see whether there is any benefit over standard laparotomy. METHODS: A case control chart review identified patients who underwent HALS for a variety of benign gynecological conditions from 2004 through 2007. Cases were then compared with a control group of all the patients who underwent similar procedures for the same diagnosis via laparotomy (ELAP) in our center within the same time period. The groups were comparable with respect to age, BMI, and surgical indication. RESULTS: Twenty-nine patients were analyzed: 12 cases (HALS) and 17 controls (ELAP). Each group was broken up into 2 subsets: Group A, older patients who underwent surgery for pelvic organ prolapse or diverticulitis with adnexectomy and Group B, younger patients who underwent surgery for pelvic pain, endometriosis, or both. Hospital stay in Group B was statistically lower in the HALS cases vs. the ELAP controls, (2.9 vs. 5.4 days, P=0.04). All HALS and ELAP patients were then analyzed for overall trends. HALS cases had shorter hospitalization than ELAP controls had (3.3 vs 4.5 days, P=0.035). Estimated blood loss was also less overall in the HALS cases vs. the ELAP controls (175 vs 355.9 mL, P=0.021). There were 2 adverse outcomes reported in Group A of the HALS cases. These 2 patients experienced postoperative hernias though the hand-assist port-site incision. CONCLUSION: Compared with laparotomy, overall, HALS offers the advantage of decreased hospitalization and decreased intraoperative blood loss. Postoperative hernias through the HA port site may be a potential problem with this technique.
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spelling pubmed-30212932011-02-17 The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease Brotherton, Joy McCarus, Steven Jones, Kathy Y. Redan, Jay Kim, John C. JSLS Scientific Papers OBJECTIVE: Hand assist laparoscopic surgery (HALS) is a surgical modality rarely used in benign gynecology. We analyzed nonmalignant pelvic disorders that utilized HALS to see whether there is any benefit over standard laparotomy. METHODS: A case control chart review identified patients who underwent HALS for a variety of benign gynecological conditions from 2004 through 2007. Cases were then compared with a control group of all the patients who underwent similar procedures for the same diagnosis via laparotomy (ELAP) in our center within the same time period. The groups were comparable with respect to age, BMI, and surgical indication. RESULTS: Twenty-nine patients were analyzed: 12 cases (HALS) and 17 controls (ELAP). Each group was broken up into 2 subsets: Group A, older patients who underwent surgery for pelvic organ prolapse or diverticulitis with adnexectomy and Group B, younger patients who underwent surgery for pelvic pain, endometriosis, or both. Hospital stay in Group B was statistically lower in the HALS cases vs. the ELAP controls, (2.9 vs. 5.4 days, P=0.04). All HALS and ELAP patients were then analyzed for overall trends. HALS cases had shorter hospitalization than ELAP controls had (3.3 vs 4.5 days, P=0.035). Estimated blood loss was also less overall in the HALS cases vs. the ELAP controls (175 vs 355.9 mL, P=0.021). There were 2 adverse outcomes reported in Group A of the HALS cases. These 2 patients experienced postoperative hernias though the hand-assist port-site incision. CONCLUSION: Compared with laparotomy, overall, HALS offers the advantage of decreased hospitalization and decreased intraoperative blood loss. Postoperative hernias through the HA port site may be a potential problem with this technique. Society of Laparoendoscopic Surgeons 2010 /pmc/articles/PMC3021293/ /pubmed/20529531 http://dx.doi.org/10.4293/108680810X12674612014941 Text en © 2010 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Brotherton, Joy
McCarus, Steven
Jones, Kathy Y.
Redan, Jay
Kim, John C.
The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease
title The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease
title_full The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease
title_fullStr The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease
title_full_unstemmed The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease
title_short The Role of Hand Assist Laparoscopic Surgery (HALS) in Pelvic Surgery for Nonmalignant Disease
title_sort role of hand assist laparoscopic surgery (hals) in pelvic surgery for nonmalignant disease
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021293/
https://www.ncbi.nlm.nih.gov/pubmed/20529531
http://dx.doi.org/10.4293/108680810X12674612014941
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