Información del artículo
Resumen
Introducción
El principal inconveniente de la cirugía laparoscópica convencional es la pérdida de la sensación táctil. En los últimos meses se han desarrollado diversos dispositivos que han permitido reconsiderar el concepto de cirugía laparoscópica asistida con la mano (CLAM), que constituye un tipo híbrido de cirugía que mantiene las características de la CL (mejor visión y más detallada) con la recuperación del tacto.
ObjetivoRevisión del estado de conocimiento actual de la CLAM.
ResultadosLa CLAM ha sido utilizada para efectuar la mayoría de las intervenciones laparoscópicas digestivas, así como urológicas, ginecológicas y vasculares, con buenos resultados iniciales, aunque en la mayoría de los casos no existen datos comparativos basados en evidencias con la cirugía abierta convencional o la laparoscópica pura.
ConclusiónLa cirugía laparoscópica asistida con la mano puede ser una interesante alternativa a la CL convencional o a la cirugía abierta, facilitando la realización de intervenciones complejas a cirujanos expertos o la iniciación en CL avanzada de los cirujanos menos entrenados. Se requieren estudios comparativos con las técnicas laparoscópicas bien establecidas para definir sus ventajas definitivas, pero puede ser un recurso antes de la conversión a cirugía abierta, ante la evidencia inicial de que mantiene las ventajas de la CL.
Palabras clave:
Cirugía laparoscópica
Cirugía laparoscópica asistida con la mano
Conversión
Introduction
The main disadvantage of conventional laparoscopy is the loss of tactile sensation. In the last few months, several devices have been developed that enable the concept of hand-assisted laparoscopic surgery (HALS) to be reassessed. HALS constitutes a type of hybrid surgery that combines the characteristics of laparoscopic surgery (better and more detailed vision) with recovery of tactile sensation. Objective. To review current knowledge of HALS.
ResultsHALS has been used to perform most gastrointestinal, urologic, gynecologic and vascular laparoscopic interventions. The preliminary results are good although in most cases, no evidence-based data comparing this technique with conventional open surgery or pure laparoscopy are available.
ConclusionHALS may be a suitable alternative to conventional laparoscopy or open surgery, facilitating the performance of complex operations by experienced surgeons and the initiation of less experienced surgeons in advanced laparoscopic techniques. Comparative studies with well-established laparoscopic techniques are required to identify its definitive advantages but, given the preliminary datasuggesting thet HALS maintains the preliminary data suggesting that HALS maintains the advantages of conventional laparoscopy, it could constitute an option to be tried before conversion to open surgery.
Key words:
Laparoscopic surgery
Hand-assisted laparoscopic surgery
Conversion
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Estudio realizado gracias a la Ayuda del FIS nº 01/173.
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