Hand-assisted laparoscopic nephrectomy: Complications related to the hand-port site

Authors

  • Chun-Hao Chen MD,

    Resident
    1. Division of Urology, Department of Surgery, Department of Medical Research, Chi Mei Medical Center, Yung Kang City, Tainan, Taiwan, ROC
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  • Chin-Li Lu,

    Master of Statistics, Statistician
    1. Division of Urology, Department of Surgery, Department of Medical Research, Chi Mei Medical Center, Yung Kang City, Tainan, Taiwan, ROC
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  • Tse-Chou Cheng MD

    Urologist
    1. Division of Urology, Department of Surgery, Department of Medical Research, Chi Mei Medical Center, Yung Kang City, Tainan, Taiwan, ROC
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Sir,

We read with interest this paper [ 1 ] about the complications related to the hand-port site during hand-assisted laparoscopic radical nephrectomy and nephroureterectomy. The authors concluded that hand-assisted laparoscopic surgery is associated with a high incidence of complications related to the hand-port wound, and abandoned the technique. They compared their results with standard laparoscopic surgery and favoured the standard procedure. However, their evidence did not support their conclusion. There were six complications in 13 patients with the hand-assisted procedure and five in 16 with the standard procedure. Using Fisher's exact test there were no differences between the groups (P = 0.422). If only the major complications are considered there were three in 13 patients with the hand-assisted procedure and one in 16 with the standard procedure; this is also not statistically significant (P = 0.277). Thus wound complications can be avoided by using the hand-port but the other complications might increase. Moreover, the authors did not state whether these operations were conducted by the same group of surgeons or not; it is unfair to compare the surgical results of different surgeons in an unrandomized study.

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