Total Colectomy and Proctocolectomy: Hand-Assisted Laparoscopic Approach

  • Marco Ettore AllaixEmail author
  • Mukta Katdare Krane
  • Alessandro Fichera


Laparoscopic surgery has been shown to potentially have several advantages over an open approach, including reduced postoperative pain, faster postoperative recovery and shorter hospital stay, reduced complication rates, and improved cosmesis. Nevertheless, a steep learning curve and the need for specialized equipment have somewhat limited the adoption of minimally invasive colorectal surgery.

Hand-assisted laparoscopic surgery (HALS) has been proposed as an alternative to conventional laparoscopy to overcome some of these limitations, in particular for challenging procedures, such as total colectomy and restorative proctocolectomy.

This chapter describes the technique and reviews some of the evidence in the literature for the HALS total colectomy with ileorectal anastomosis and the HALS proctocolectomy with ileoanal pouch.


Laparoscopic colorectal surgery Hand assisted laparoscopic surgery Total colectomy Ileorectal anastomosis Proctocolectomy Ileoanal pouch Ulcerative colitis Familial adenomatous polyposis 

Supplementary material

Video 21.1

Ileocolic vessel ligation (M4V 7085 kb)

Video 21.2

Medial colon mobilization (M4V 5992 kb)

Video 21.3

Lateral colon mobilization (M4V 7491 kb)

Video 21.4

Ileum mobilization (M4V 6507 kb)

Video 21.5

Hepatic flexure mobilization (M4V 9615 kb)

Video 21.6

Gastrocolic ligament opening (M4V 10886 kb)

Video 21.7

Splenic flexure mobilization (M4V 8827 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Marco Ettore Allaix
    • 1
    Email author
  • Mukta Katdare Krane
    • 1
  • Alessandro Fichera
    • 2
  1. 1.Department of SurgeryUniversity of Chicago MedicineChicagoUSA
  2. 2.Department of SurgeryUniversity of WashingtonSeattleUSA

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