Should Hand-Assisted Laparoscopic Surgery Be Placed in the Realm of Minimally Invasive Surgery?

own advantages [2-4]. The authors compared a HALS right hemicolectomy with an open right hemicolectomy. In common with many other reports in the literature, they found the HALS technique to be equal to or better than open surgery with respect to postoperative clinical parameters [5, 6]. Among the several advantages of HALS, the authors particularly emphasized restoration of tactile feedback to surgeon’s hand during the procedure. This point is very different from conventional laparoscopic surgery and contributes greatly to the surgery being easier and shorter. In my own view, this point also supports surgeon’s emotional stability by increasing self-confidence. Because the surgeon’s hand is in patient’s abdomen, handling unexpected situations that may happen during surgery is much easier and faster than it is with conventional laparoscopic surgery. Conventional laparoscopic surgery is still criticized because of its being a demanding technique, lacking tactile sensation, prolonging procedural time and having a steep learning curve. I am certain that as long as these drawbacks of the in conventional technique exist, HALS will continue to be an option for surgeons. To support the superiority of the HALS technique, the authors should analyze long-term survival data in the future. Furthermore, in the current minimally invasive surgery era, a comparison between HALS and conventional laparoscopic surgery is essential for correct positioning. In conclusion, I believe that the hand of an experienced surgeon is the best instrument in the operating room. Technical improvement and development of high-end instruments for HALS is needed if it is to gain wide popularity among surgeons.