Hand-assisted Laparoscopic Surgery (HALS) as an Alternative to Laparoscopic Converted to Open Surgery (LCOS) in Proctectomy Patients

We believe this is the first large national database study comparing HALS and LCOS approaches for proctectomies. Multivariate logistic regression confirmed that HALS was associated with better postoperative outcomes compared with LCOS. In complex cases, starting with the HALS approach may be more advantageous than the SLS method. Furthermore, hand assistance should be considered before converting to open surgery in challenging laparoscopic cases.