For patients with colorectal cancer who require the surgical removal of a part of their colon (colectomy), an experimental procedure may decrease the time they spend in the operating room (OR). The procedure combines both the benefits of laparoscopic surgery and open surgery. Surgeon-scientists from NewYork-Presbyterian Hospital and its academic affiliates are currently recruiting patients for a clinical research study to test this hypothesis.
The study to compare hand-assisted laparoscopic surgery (HALS) with standard laparoscopic surgery (SLS) is being conducted at sites including NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian/Columbia University Medical Center, in conjunction with its academic partners Weill Medical College of Cornell University and Columbia University College of Physicians and Surgeons.
Dr. Jeffrey Milsom, the DeCosse Distinguished Professor of Surgery at Weill Medical College of Cornell University and attending surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, explains how the procedure works: "While the patient is asleep under general anesthesia, we make a small incision in the pubic area and put in place a device called the GelPort® that creates a kind of doorway to the patient's abdomen. The surgeon inserts one hand through this device to locate the affected area of the colon. Using the other hand, the surgeon inserts laparoscopic instruments through one or two additional small incisions to move the section of affected colon outside the abdomen through the Gelport device -- here it becomes a sort of open surgery -- and cuts away the affected area. Finally, sewing everything up, the colon is restored in its normal place."
The GelPort device also acts to seal in gas that is introduced into the abdominal cavity to give the surgeon more room during the laparoscopic portion of the procedure.
Dr. Richard L. Whelan, chief of colon and rectal surgery at NewYork-Presbyterian/Columbia University Medical Center and associate professor of surgery at Columbia University College of Physicians and Surgeons, explains some potential benefits of the surgery, compared to standard laparoscopic surgery: "Hand-assisted surgery gives surgeons a sense of touch which helps identify the affected area of the colon and helps to better control any bleeding. Also, because the colon is resected outside the abdomen, a sometimes difficult and laborious laparoscopic resection is not necessary. Our study may show that these advantages help cut down on the time of the surgery."
Hand-assist devices are currently used for other abdominal surgeries, including for the stomach and spleen.