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Hand-Assisted Laparoscopic Surgery, or HALS, is a variation of laparoscopic surgery. This technique recognizes the fact that the human hand is the ideal surgical instrument. The human hand has dexterity and flexibility that is unmatched by any surgical instrument. In addition, the human hand allows the surgeon to have sensory feedback, which makes the operation safer as the surgeon will have a greater sense of depth and sensation of touch to guide his dissection.

In traditional open surgery, this is not an issue. The surgeon’s hands will be able to access the tissues and organs he is operating on. However, in laparoscopic surgery, where the surgeon uses thin and long instruments to operate, there is a loss of tactile sensory feedback. Thus far, no laparoscopic instrument is able to replicate the human hand.

Surgeons have thus developed HALS, in which the surgeon is able to insert one of his hands into the abdominal cavity to assist in the laparoscopic operation. It is particularly useful for operations where a small incision is required to remove the diseased organ from the body. Since a small incision is required, this same incision can be used to insert of one of the surgeon’s hands to assist in the operation.

In HALS, the surgeon will insert his non-dominant hand through a small incision via a special hand-port. This hand-port is a specialised port that allows the insertion of the surgeon’s hand without leakage of the gas that is pumped into the abdomen. This gas creates a wide space within the abdomen, called the pneumoperitoneum, that allows laparoscopic operation to proceed.




Using his non-dominant hand to guide the laparoscopic instruments, the surgeon then performs the operation while observing the entire procedure on a TV screen, just like a conventional laparoscopic operation. With one of his hands inside, the surgeon has more control.

Key benefits of HALS include:

  1. Provide sensory feedback
  2. Enhanced safety by giving the surgeon more control, especially for complex procedures
  3. Reduced the need to convert to an open surgery for the complex laparoscopic procedures

The HALS technique has been used to perform many types of surgery including:

  1. Removal of part of the colon (hemicolectomy, anterior resection)
  2. Removal of stomach (gastrectomy)
  3. Removal of part of the liver (hepatectomy)
  4. Removal of a large spleen (splenectomy)
  5. Removal of kidneys (nephrectomy)

Should you require further assistance, please do not hesitate to contact Nexus Surgical Laparoscopic and MIS Centre.


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