Hand-assisted laparoscopic digestive surgery provides safety and tactile sensation for malignancy or obesity

Background: Some of the persistent problems associated with laparoscopic su rgery stem from the inability of the surgeon to palpate the abdominal conte nts during the operation. This lack of tactile sensation can lead to poor a bdominal exploration, difficulty in extracting the organs, and a relatively long operation time compared to conventional procedures. The Dexterity Pne umo Sleeve is a new device that allows the surgeon to insert his or her han d into the abdominal cavity through a small incision while preserving the p neumoperitoneum. Methods: Recently, 13 of our patients underwent hand-assisted advanced lapa roscopic surgery using this device. In this series, we had two cases of gas trectomy, two cases of gastric bypass for morbid obesity, two Whipple cases for periampullary tumor, and seven cases of bowel resection. On the basis of this series, we were able to assess the utility of this device. Results: Satisfactory pneumoperitoneum was maintained in 12 of 13 cases. Th e length of the skin incision was 7.8 cm on average, which was almost the s ame size as surgeon's glove. The device proved to be very useful for tissue retraction and abdominal exploration in all cases and for intracorporeal k not tying in some cases. Conclusions: We found that the device permitted an easier dissection, resec tion, and anastomosis. It also helped to decrease the operation time.