“Despite mounting evidence of substantial short-term advantages of MIS over open surgery, MIS remains grossly underused in patients with CRC. Our experience has shown that the development of a program to overcome the impediments to MIS enables a rapid increase in the use of MIS, with substantial benefits to both patients and hospitals.

The advantages for patients and hospitals are outlined above. The advantages for surgeons include higher operative volumes, excellent clinical outcomes, and, most importantly, the chance to do the right thing. Furthermore, the development of a MIS CRC program provides increased educational and research opportunities, enhancing the academic mission and paving the way for exciting new discoveries."

"We believe that HALS has many technical advantages over the purely laparoscopic technique when dealing with a massive spleen. Compared with standard laparoscopic instruments, the hand allows for greater atraumatic exposure of the spllen. The hand also allows for easy tamponade of any bleeding that may be encountered during dissection, which is often a reason for conversion to open splenectomy and excessive blood loss. The hand eases the technically challenging manipulation of the spleein into a retrieval bag. The hand port also adds little incisional morbidity, as a larger utility port is often required for spleen removal in laparoscopic splenectomy.

CONCLUSION “When compared with open splenectomy, HALS resulted in a significantly reduced length of stay in hospital. It is a valuable technique to have in the surgeon’s armamentarium when treating patients with splenomegaly.”