Overall Comparison

Overall, the published data suggest that hand-assisted laparoscopy is generally faster than standard transperitoneal laparoscopy, but that several factors alter the impact of hand-assisted laparoscopy with regard to operative time.

The intensity and duration of postsurgical recovery appears to be slightly increased by hand-assisted laparoscopy, but the magnitude of the difference between hand-assisted laparoscopy and standard laparoscopy is much less than that between handassisted laparoscopy and open surgery. For advanced procedures such as donor nephrec-tomy, hand-assisted laparoscopy appears to reduce the likelihood of conversion to open surgery.

The benefit of hand-assisted laparoscopy is greater in the setting of more complex procedures (such as nephroureterectomy and donor nephrectomy), but is less when there is extensive prior experience or when compared to retroperitoneoscopy.

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