ABSTRACT
I. INTRODUCTION Laparoscopic surgery has afforded significant benefits over conventional open surgery and thus has been incorporated into the surgeons' armamentarium. Laparoscopic techniques progressed from being utilized by a few surgical pioneers to ultimately being established as the gold standard for certain common procedures. Hand-assisted laparoscopic surgery (HALS) has acquired a role in the evolution of laparoscopy. The limitations of laparoscopic surgery such as loss of direct tactile sensation, diminished depth perception, and retrieval of organs are compensated by the insertion of a hand into the laparoscopic field. Leahy et al. first reported the concept of HALS in 1994 [1]. Initially the gloved hand was inserted into the abdomen via a small incision and pneumoperitoneum maintained by apposition of the wound edges [2]. In 1996 Bannenberg and associates reported a handassisted laparoscopic nephrectomy in a porcine model using a prototype device [3].
