Laparoscopic gastrectomy in the porcine model: our initial experience with a new hand-assist device.

Many advanced laparoscopic cases remain technically difficult and are less widely accepted. To a great extent, advanced laparoscopic surgery is handicapped by the loss of a surgeon's tactile sense. The concept of introducing the surgeon's hand as an aid to minimally invasive surgery has been described. We report a new hand-assist device designed to allow the introduction of the surgeon's hand, wrist, and forearm through a small incision in the abdomen to assist laparoscopic surgery with pneumoperitoneum. Important factors in the hand-assist design are ease of use, reliable maintenance of pneumoperitoneum, and minimal hand/arm fatigue, which were met with this device.