Re: JSLS(2009)13(4):484–488. Hand-assist Laparoscopic Surgery for the Gynecologic Surgeon

The authors quoted 4 papers related to the use of handassisted laparoscopy in gynecologic cancer while ignoring the first contribution to the literature on the subject published by us in 2000.6 We were the first to report the value of the technique as an effective and safe method to facilitate the completion of complex oncologic procedures that may otherwise require a lengthy, difficult and risky conventional laparoscopic surgery or conversion to laparotomy. At the time–exactly one decade ago–we had already reported the value of hand-assisted laparoscopy in surgical staging and the value of the hand port to allow a simplified, uncontaminated, and rapid removal of an intact tumor, omentum, and lymph nodes. We also reported the simplicity of hand-assisted omentectomy and lymph node dissection.