Hand assistance is an alternative to conversion to laparotomy during laparoscopic sigmoidectomy

Autor: Carlos Belmonte Montes, Pablo Daniel Murakami Morishige, Adrián Murillo Zolezzi, Hernán Maydon González, Sergio Alejandro Toledo Valdovinos
Rok vydání: 2009
Předmět:
Zdroj: Cirugía Española (English Edition). 86:346-350
ISSN: 2173-5077
DOI: 10.1016/s2173-5077(09)70105-x
Popis: Introduction Laparoscopic surgery in the treatment of diverticular disease offers multiple benefits compared with its open surgery counterpart. There are 2 distinct techniques, the laparoscopically assisted and the laparoscopic hand assisted approach. The purpose of this study is to demonstrate that the hand assisted approach can be used if, during a laparoscopically assisted approach, there is difficulty in dissection and/or exposure, and before performing a laparotomy. Material and methods This study is a retrospective cohort series that was performed in a private tertiary hospital in Mexico City. Patients with the diagnosis of diverticular disease who underwent a laparoscopically assisted sigmoidectomy were selected. These included patients who, during their procedure required conversion to a hand assisted approach. Results A total of 47 sigmoid colectomies began with assisted laparoscopy, of which 33 were completed, 4 required laparotomy, and 10 where completed using hand assistance (none required laparotomy). There were no statistically significant differences in return of bowel function (P = .879) and postoperative hospital stay (P = .679) between the group that was completed by assisted laparoscopy versus hand assisted. Conclusions If there is difficulty in exposure or dissection during a laparoscopically assisted sigmoid colectomy, the hand assisted approach is an alternative before the laparotomy.
Databáze: OpenAIRE
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