2009 Volume 68 Issue 6 Pages 326-331
BACKGROUND: We introduced hand-assisted laparoscopic gastrectomy (HALG) for gastric disease in Jan. 2005. Herein, we present our operative procedure and the results, and then evaluate the feasibility of HALG. METHOD: From January 2005 to Jun 2009, we performed hand-assisted laparoscopic distal gastrectomy/pylorus preserving gastrectomy (HALDG/HALPPG) in 63 patients, hand-assisted laparoscopic total gastrectomy (HALTG) in 19 patients and handassisted laparoscopic proximal gastrectomy (HALPG) in 13 patients. In each procedure, GelportTM was attached to the 7 cm minilaparotomy of the xiphoid process and two 12-mm-trocars and two 5-mm-trocars were inserted into the same locations respectively. Reconstruction in HALDG/HALPPG implemented Billroth-I or Roux-en-Y, in HALTG implemented Roux-en-Y and in HALPG implemented Jejunal pouch interposition. In all cases, we performed the reconstruction through the minilaparotomy of the xiphoid. RESULTS: The average operating time was 209, 251 and 229 min for HALDG/HALPPG, HALTG, and HALPG, respectively. The average blood loss was 50 g, 134 g, 91 g and the average postoperative stay was 13 days, 17 days, 14 days, respectively. There were no perioperative complications and conversion to open surgery was not necessary in any of the cases. CONCLUSION: HALG is easily acceptable for surgeons who are accustomed to open surgery. We believe that HALG is feasible and one of the good options for surgery of gastric disease.
