Hand-Assisted Laparoscopic Colectomy

Today, many patients needing non-emergent removal of a portion of their large intestine (colon) are candidates for this revolutionary technique.  This newer surgical approach to the contents of the abdomen is also being used for other abdominal procedures.

Hand-assisted laparoscopic surgery (HALS) allows a surgeon the ability of combining the use of one hand in the abdomen, through a three and one half to four inch incision, while the other hand manipulates standard laparoscopic instruments from outside of the abdomen.   Tiny incisions are made on the abdominal wall to place trocar/port sites so that these various instruments can be interchanged as needed to perform the operation.  This dual approach allows the surgeon the ability to not only “feel” various tissues in the abdomen but also the added benefit in assisting with the dissection and/or mobilization of tissues.  The patient benefits from smaller surgical cuts on the abdomen, a quicker return to eating regular foods, less pain, and a shorter stay in the hospital.  HALS does require a general anesthetic such that the patient is fully asleep and without consciousness.

Pioneering efforts at hand-assisted abdominal surgery began in the United States around 1996. Modifications to allow access of the surgeon’s hand during laparoscopic operations took a foothold around 1999.  Today, the majority of elective colon procedures are done with HALS.  This same technology is being used by many surgeons for operations involving the small intestine, spleen, pancreas, and kidney.

Colon polyps (mushroom-like growths), recurrent bouts of diverticulitis, and colon cancer are typical diseases that patients have when visiting a General Surgeon to discuss considerations for elective (non-emergent) removal of part of their colon.  Your surgeon can discuss the amount of colon that is recommended to be removed and the reasonable expectations concerning your planned colon surgery.  Though many precautions around the time of surgery are taken by both the surgeon and the anesthesia team to lower risks, all operations have risks.  The time to ask questions pertaining to your surgery is before the operation.
 
Following HALS for colon diseases, most patients are out of bed/walking the morning after surgery, drinking liquids by the second day after surgery, and going home around four days post-operatively.  The largest scar on the abdomen is usually only three and one half to four inches long.  Driving and lifting restrictions are discussed with you by the surgeon prior to your leaving the hospital.  Showering can usually begin upon discharge from the hospital.  Frequent walking lowers your risk for dangerous blood clots which can develop in the legs or pelvis.  A follow up appointment with your surgeon will occur usually within 10 days from the date of surgery.