PTU - Polskie Towarzystwo Urologiczne
list of articles:

Hand Assisted Laparoscopy in Urology
Article published in Urologia Polska 2002/55/3.

authors

Sławomir Paweł Woźniak, Romuald Zdrojowy, Janusz Dembowski
Katedra i Klinika Urologii Akademii Medycznej we Wrocławiu
Kierownik katedry i kliniki: prof, dr hab. Jerzy Lorenz

keywords

laparoscopy, nephrectomy, nephrourcterectomy, adrenalectomy

summary

In order to reduce the technical challenge of urologie laparoscopic surgery, investigators have introduced the concept ot „hand-assisted laparoscopy\".
HAL is a hybrid technique that incorporates features of both standard laparoscopy and open surgery. The surgeon\'s dominant hand controls the laparoscopic instruments used for dissection, suturing, clip application, etc. The surgeon\'s non-dominant hand replaces a laparoscopic instrument: It enters the abdominal cavity through a 7 cm incision to palpate tissues, providing the surgeon with spatial orientation and tactile sensation, as in open surgery. A laparoscope provides the view of the operative field. The presence of the hand allows for tactile sensation, a 3-dimensional spatial orientation, tissue palpation, blunt dissection and retraction. The hand in the wound plays the role of the non-dominant hand in open surgery: It works in concert with the instrument-bearing hand for effective and safe tissue dissection. When bleeding occurs, the hand provides prompt and secure hemostasis, allowing exposure, clip application or suture ligature, lntracorporeal knot tying is similar to the technique used in open surgery. The learning curve appears to be less sleep for hand-assisted laparoscopy.

references

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correspondence

Sławomir Paweł Woźniak
ul. Białoruska 10
54-425 Wrocław