Hand-assisted laparoscopic (HAL) gastric partition with roux-en-Y intestinal bypass.

The surgical treatment of obesity with proximal gastric partition and Roux-en-Y intestinal bypass is recognized as effective in producing meaningful weight loss of excess body weight. Pure laparoscopic surgery has been perfected by a small number of surgeons in the United States. To acquire this new skill requires extensive training and supervision. In the hands of inexperienced operators, it is associated with prolonged surgery times and significant complications. Hand-assisted laparoscopic (HAL) surgery has been developed as an alternative method of minimally invasive surgery that can increase the number of surgeons who can offer laparoscopic surgery to their obese patients while decreasing the case load necessary to obtain expertise. The technique and approach of HAL surgery is presented in detail.