Laparoscopic Hand-Assisted Low Anterior Resection

  • Govind NandakumarEmail author
  • Sang W. Lee


Laparoscopy for colon surgery is safe and effective. Laparoscopic rectal surgery remains technically challenging, and long-term oncologic outcomes to date are still under investigation. Hand-assisted laparoscopic surgery preserves several advantages of laparoscopy while decreasing operative time and expanding the reach of laparoscopy. This chapter focuses on the technical aspects of hand-assisted laparoscopic low anterior resection.


Total Mesorectal Excision Inferior Mesenteric Artery Inferior Mesenteric Vein Laparoscopic Total Mesorectal Excision Hand Port 
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Supplementary material

Video 11.1

Hand-assisted laparoscopic rectal mobilization (MP4 70782 kb)


  1. 1.
    Bonjer HJ, Hop WC, Nelson H, Sargent DJ, Lacy AM, Castells A, Guillou PJ, Thorpe H, Brown J, Delgado S, Kuhrij E, Haglind E, Påhlman L, Transatlantic Laparoscopically Assisted vs Open Colectomy Trials Study Group. Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis. Arch Surg. 2007;142(3):298–303.PubMedCrossRefGoogle Scholar
  2. 2.
    Nakajima K, Lee SW, Cocilovo C, Foglia C, Kim K, Sonoda T, Milsom JW. Hand-assisted laparoscopic colorectal surgery using GelPort. Surg Endosc. 2004;18(1):102–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Sonoda T, Pandey S, Trencheva K, Lee S, Milsom J. Longterm complications of hand-assisted versus laparoscopic colectomy. J Am Coll Surg. 2009;208(1):62–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Nakajima K, Milsom JW, Margolin DA, Szilagy EJ. Use of the surgical towel in colorectal hand-assisted laparoscopic surgery (HALS). Surg Endosc. 2004;18(3):552–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Meshikhes AW. Controversy of hand-assisted laparoscopic colorectal surgery. World J Gastroenterol. 2010;16(45):5662–8.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    HALS Study Group. Hand-assisted laparoscopic surgery vs standard laparoscopic surgery for colorectal disease: a prospective randomized trial. Surg Endosc. 2000;14(10):896–901.CrossRefGoogle Scholar
  7. 7.
    Marcello PW, Fleshman JW, Milsom JW, Read TE, Arnell TD, Birnbaum EH, Feingold DL, Lee SW, Mutch MG, Sonoda T, Yan Y, Whelan RL. Hand-assisted laparoscopic vs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum. 2008;51(6):818–26.PubMedCrossRefGoogle Scholar
  8. 8.
    Tjandra JJ, Chan MK, Yeh CH. Laparoscopic- vs hand-assisted ultralow anterior resection: a prospective study. Dis Colon Rectum. 2008;51(1):26–31.PubMedCrossRefGoogle Scholar
  9. 9.
    Chang YJ, Marcello PW, Rusin LC, Roberts PL, Schoetz DJ. Hand-assisted laparoscopic sigmoid colectomy: helping hand or hindrance? Surg Endosc. 2005;19(5):656–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Champagne BJ, Lee EC, Valerian B, Armstrong D, Ambroze W, Orangio G. A novel end point to assess a resident's ability to perform hand-assisted versus straight laparoscopy for left colectomy: is there really a difference? J Am Coll Surg. 2008;207(4):554–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Colon and Rectal Surgery, Department of SurgeryWeill Cornell Medical CollegeNew YorkUSA

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