Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different?

Published

Journal Article

BACKGROUND: HAL colectomy is a technique perceived to provide the benefits of laparoscopic surgery while improving tactile feedback and operative time. Published data are largely limited to small, single-institution studies. METHODS: The 2012-2013 National Surgical Quality Improvement Program Participant Data Use File was queried for patients undergoing elective SL or HAL colectomy. Patients underwent 1:1 propensity matching and had outcomes compared. An additional subgroup analysis was performed for patients undergoing segmental resections only. RESULTS: 13,949 patients were identified, of whom 6084 (43.6 %) underwent HAL colectomy. Patients undergoing HAL versus SL colectomy had higher rates of postoperative ileus (8.7 vs. 6.3 %, p < 0.001), wound complication (8.8 vs. 6.8 %, p = 0.006), and 30-day readmission (7.5 vs. 6.0 %, p = 0.002), without any differences in operative time (156 vs. 157 min, p = 0.713). Amongst segmental colectomies, HAL remained associated with higher rates of wound complications (8.6 vs. 6.5 %, p = 0.016), postoperative ileus (8.9 vs. 6.3 %, p < 0.001), and 30-day readmission (7.1 vs. 5.9 %, p = 0.041) with no difference in operative time between HAL and SL (145 vs. 145 min, p = 0.334). CONCLUSIONS: Use of HAL colectomy is associated with increased risk of wound complications, postoperative ileus, and readmissions. Importantly, this technique is not associated with any decrease in operative time.

Full Text

Duke Authors

Cited Authors

  • Gilmore, BF; Sun, Z; Adam, M; Kim, J; Ezekian, B; Ong, C; Migaly, J; Mantyh, CR

Published Date

  • November 2016

Published In

Volume / Issue

  • 20 / 11

Start / End Page

  • 1854 - 1860

PubMed ID

  • 27456018

Pubmed Central ID

  • 27456018

Electronic International Standard Serial Number (EISSN)

  • 1873-4626

Digital Object Identifier (DOI)

  • 10.1007/s11605-016-3206-z

Language

  • eng

Conference Location

  • United States