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

Publication ,  Journal Article
Gilmore, BF; Sun, Z; Adam, M; Kim, J; Ezekian, B; Ong, C; Migaly, J; Mantyh, CR
Published in: J Gastrointest Surg
November 2016

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.

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Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

November 2016

Volume

20

Issue

11

Start / End Page

1854 / 1860

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Operative Time
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans
 

Citation

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ICMJE
MLA
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Gilmore, B. F., Sun, Z., Adam, M., Kim, J., Ezekian, B., Ong, C., … Mantyh, C. R. (2016). Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different? J Gastrointest Surg, 20(11), 1854–1860. https://doi.org/10.1007/s11605-016-3206-z
Gilmore, Brian F., Zhifei Sun, Mohamed Adam, Jina Kim, Brian Ezekian, Cecilia Ong, John Migaly, and Christopher R. Mantyh. “Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different?J Gastrointest Surg 20, no. 11 (November 2016): 1854–60. https://doi.org/10.1007/s11605-016-3206-z.
Gilmore BF, Sun Z, Adam M, Kim J, Ezekian B, Ong C, et al. Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different? J Gastrointest Surg. 2016 Nov;20(11):1854–60.
Gilmore, Brian F., et al. “Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different?J Gastrointest Surg, vol. 20, no. 11, Nov. 2016, pp. 1854–60. Pubmed, doi:10.1007/s11605-016-3206-z.
Gilmore BF, Sun Z, Adam M, Kim J, Ezekian B, Ong C, Migaly J, Mantyh CR. Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different? J Gastrointest Surg. 2016 Nov;20(11):1854–1860.
Journal cover image

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

November 2016

Volume

20

Issue

11

Start / End Page

1854 / 1860

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Operative Time
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans