Is There Still a Role for Hand-Assisted Laparoscopic Surgery (HALS)?

  • Nicholas Gerard Berger
  • Timothy J. Ridolfi
  • Kirk A. LudwigEmail author


Laparoscopy has been widely adopted for a variety of abdominal operations, and laparoscopic colorectal surgery has been shown to be oncologically equivalent and superior in terms of perioperative pain, length of stay, and decreased complications compared to traditional open surgery. However, laparoscopic colon surgery is fraught with a steep learning curve, longer operative times, and high conversion rates compared to traditional open surgery. Hand-assisted laparoscopic surgery (HALS) is an alternative to laparoscopic colon surgery which has been shown in several randomized controlled trials to have similar perioperative outcomes with decreased operative times and lower conversion rates. While some consider HALS an intermediate option for those developing the skills or volume in laparoscopic colorectal surgery, this chapter discusses how HALS colorectal surgery can be utilized as an effective first option with advantages over open surgery and similar short-term benefits seen with straight laparoscopic colorectal surgery. This is especially the case in the context of complicated operations, extended resections, and operations conducted in overweight or obese patients. The authors firmly believe that the HALS approach is a valuable technique for the minimally invasive colorectal surgeon.


Hand-assisted laparoscopy Laparoscopy Colectomy Colon surgery HALS Colorectal cancer Ulcerative colitis Crohn’s colitis Perioperative outcomes 


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Nicholas Gerard Berger
    • 1
  • Timothy J. Ridolfi
    • 1
  • Kirk A. Ludwig
    • 1
    Email author
  1. 1.Department of Surgery, Division of Colorectal SurgeryMedical College of Wisconsin, Froedtert Memorial Lutheran HospitalMilwaukeeUSA

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