Feasibility of hand-assisted laparoscopic surgery (HALS) in gynecologic oncology patients.

Academic Article

Abstract

  • 5153 Objective: Although hand-assisted laparoscopic surgery (HALS) has been utilized in multiple surgical procedures, limited data exists on the use of HALS for gynecologic oncology indications. Our goal was to evaluate the indications, potential benefits, and complications of HALS in cases of suspected gynecologic malignancy. METHODS: We performed a retrospective chart review of patients who had an HALS procedure performed from 1/03 until 10/04. Data was collected on patient demographics, indications for surgery, operative morbidity, and length of stay. RESULTS: 37 patients who underwent a HALS procedure were identified. The median age was 51 years (range, 19-86) and the mean BMI was 28.7 m2 (range, 17.8-40.7). The indications for surgery included pelvic mass (n=29), prophylactic oophorectomy (n=2), secondary cytoreduction for ovarian cancer (n=2), uterine fibroids (n=2), surgical staging for endometrial cancer (n=1), post-menopausal bleeding (n=1), and vaginal vault prolapse (n=1). The mean estimated size of pelvic mass removed was 11.2 cm (range, 3-30). 6 of 29 (21%) patients with a pelvic mass were diagnosed with an ovarian carcinoma. All patients underwent general endotracheal anesthesia for the following procedures performed: oophorectomy (n=31), lysis of adhesions (n=14), surgical staging (n=9), hysterectomy (n=9), loop colostomy (n=1), and sacrocolpo suspension (n=1). Mean operating time was 90 minutes (range, 46-157) with mean estimated blood loss of 110 cc (range, 10-400). One patient was converted to laparotomy due to a large unresectable mass. One intraoperative complication of epigastric vessel injury due to trocar placement occurred. The average length of post-operative hospital stay was 2.8 days (range, 2-5). 4 of 37 (11%) patients experienced a post-operative complication including ileus (n=2), pre-renal azotemia (n=1), and transfusion of packed red blood cells (n=1). CONCLUSIONS: HALS is an innovative surgical technique that allows a number of surgical procedures to be accomplished in gynecologic oncology patients. HALS appears to be safe and feasible based on acceptable operating time, estimated blood loss, conversion rate, complication rate, and length of hospital stay. No significant financial relationships to disclose.
  • Published In

    Author List

  • Spannuth WA; Rocconi RP; Straughn JM; Huh WK; Barnes MN
  • Start Page

  • 5153
  • Volume

  • 23
  • Issue

  • 16_suppl