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Invited Critique |

Hand-Assisted Laparoscopic Surgery—Invited Critique

James C. Rosser Jr, MD
Arch Surg. 2003;138(2):141. doi:10.1001/archsurg.138.2.141.
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One of the most useful contributions to the literature, which helps the surgeon at the grassroots level, is a review of an emerging or controversial topic. The authors of this article did not disappoint. Their thorough review of the literature on HALS was excellent. The article helps to put into perspective the proposed clinical applicability of what I call "bridging technology devices."

Probably the most credible reason to embrace these appliances is that they may help to prevent the conversion of a laparoscopic to an open procedure. However, a 7-cm incision, suggested in the manuscript as being necessary to use the device, is suspect at best. Many surgeons would need a larger incision. With this in mind, some would argue that an open procedure using standard equipment could be performed without added expense.

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