ABSTRACT
BACKGROUND: Hand-assisted laparoscopic surgery is useful in difficult laparoscopic operations. Expensive and cumbersome devices are necessary to ensure airtightness between the surgeon's hand and the abdominal wall so that pneumoperitoneum can be maintained. METHOD: A simple method of maintaining pneumo-peritoneum in hand-assisted laparoscopic surgery was carried out by tying a strong nylon suture in a criss-cross fashion on one end of the incision. Airtightness was maintained by tightening the suture around the wrist and wedging the dorsum of the hand against the abdominal wall. RESULT: The method was used successfully to remove a pyonephrotic left kidney in a 28-year-old man from Papua New Guinea. CONCLUSION: Hand-assisted laparoscopic operations can be carried out expediently and inexpensively without specialized equipment by simply tying a shoestring suture at one end of the wound.
