J Korean Soc Coloproctol.  2009 Dec;25(6):380-386. 10.3393/jksc.2009.25.6.380.

A Comparison of Standard Laparoscopic Surgery and Hand-Assisted Laparoscopic Surgery in Patients with Diverticular Diseases of the Large and the Small Bowel

• Jung JH
• Kim CN
• Park JS
• Kim JY
• Cho BS
• Lee MK
• Choi YJ
• Kang YJ
• Park JS

• KMID: 2101490
• DOI: http://doi.org/10.3393/jksc.2009.25.6.380

Abstract

PURPOSE
In complicated diverticular disease, hand-assisted laparoscopic surgery (HALS) has been considered as a useful alternative treatment to standard laparoscopic surgery (SLS) and open surgery. As compared with standard laparoscopic surgery, HALS offers advantages such as tactile sense, better exposure, and shorter learning curve. Minimally invasive surgery is another advantage of HALS. The aim of this study was to compare SLS to HALS in patients with diverticular diseases of the small bowel and the colon. METHODS: We retrospectively reviewed the records of 32 patients who had undergone SLS and HALS for diverticular disease between February 2002 and March 2009. RESULTS: Of the 32 patients, 20 patients (62.5%) were in the SLS group, and 12 patients (37.5%) were in the HALS group. The mean maximal incision length was longer in the HALS group (SLS group vs. HALS group, 4.5 vs. 7.4 cm, P<0.001). However, the mean operating time, the time to flatus, the time to diet, the mean duration of narcotic analgesia, the length of hospital stay, and the postoperative complications were similar. There was no mortality in either group. CONCLUSION: The longest incision length for the HALS group was longer than that for the SLS group, but HALS could reduce the conversion rate and has the many advantages of minimally invasive surgery. For complicated diverticular disease, HALS may be considered as a useful alternative treatment.

Keyword

Diverticular disease; Standard laparoscopic surgery; Hand-assisted laparoscopic surgery

MeSH Terms

Analgesia
Colon
Diet
Flatulence
Hand-Assisted Laparoscopy
Humans
Imidazoles
Laparoscopy
Learning Curve
Length of Stay
Nitro Compounds
Postoperative Complications
Retrospective Studies
Imidazoles
Nitro Compounds