Laparoscopic total mesorectal excision can be a very challenging procedure. Two recent large randomized controlled trials could not show it was not inferior to open surgery [1, 2]. Hand-assisted laparoscopic… Click to show full abstract
Laparoscopic total mesorectal excision can be a very challenging procedure. Two recent large randomized controlled trials could not show it was not inferior to open surgery [1, 2]. Hand-assisted laparoscopic surgery, which is a bridge between the open and laparoscopic surgery, may be the clue to working in a deep, narrow pelvis, with bulky mesorectum [3]. The additional hand port enables proper traction and counter traction, palpation of the structures, and shortens the operating time without negatively affecting outcomes.
               
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