World Journal of Laparoscopic Surgery

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VOLUME 2 , ISSUE 2 ( May-August, 2009 ) > List of Articles


Hand Assisted Laparoscopic Appendicectomy (HALA): A Safe Alternative Minimal Access Technique

Aswini Kumar Misro, Radhika Mishra, ML Shrestha

Citation Information : Misro AK, Mishra R, Shrestha M. Hand Assisted Laparoscopic Appendicectomy (HALA): A Safe Alternative Minimal Access Technique. World J Lap Surg 2009; 2 (2):12-14.

DOI: 10.5005/jp-journals-10007-1017

Published Online: 01-08-2011

Copyright Statement:  Copyright © 2009; The Author(s).



Appendicectomy is a commonly performed surgical procedure. Conventional open appendicectomy is sometimes met with difficulties, particularly when the appendix is malpositioned, in obese patients and patients having peritonitis. On the other hand, laparoscopic appendicectomy conferring several advantages over the open technique is time consuming and requires complex maneuvers like intra and extracorporeal knotting. Understanding the advantages and disadvantages of the above two techniques, we have been using a combination of both which we will be terming as ‘Hand Assisted Laparoscopic Appendicectomy (HALA)’.

Material and methods

83 cases were subjected to appendicectomy using the mentioned technique both for acute and recurrent cases. Patients having gangrenous appendicitis or with necrotic and friable appendix were excluded from the study.

Observations and results

The results are as follows:

1. Duration of hospital stay: 2.4 days

2. Wound infection: 5/83

3. Duration of follow-up: till 1 month postoperative.

4. Paralytic ileus: 3/83

5. Operating time (mean): 30 minutes.


Hand assisted laparoscopic appendicectomy (HALA) is a safe alternative technique providing all advantages of minimal access surgery while reducing the complexities associated with it.

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  2. Randomized controlled trial comparing laparoscopic and open appendectomy. Br J Surg 1993;80:1599-1600.
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