Urologic surgery encompasses a wide range of surgical technique such as open surgery, transperitoneal or retroperitoneal laparoscopic surgery, hand -assisted laparoscopic surgery (HALS), and robotic surgery. A few years after the introduction of conventional laparoscopic radical nephrectomy in 1991 where the kidney was morcellated in a bag and then extracted through a 12-mm incision, hand-assisted laparoscopic radical nephrectomy was developed, allowing intra-abdominal manipulation of the specimen with a hand and using at the beginning of the operation the incision typically created for the removal of intact surgical specimen. Using HALS, a hand exactly, surgeons can transfer many open surgical skills to
the less invasive approach. HALS is useful when the kidney is going to be removed intact or when a troublesome dissection is expected. The utility of HALS for donor nephrectomy has been demonstrated in several reports. Some HALS proponents apply the surgery even to partial nephrectomy, autosomal polycystic kidneys, and pyeloplasty. Although sticking to the sole technique is not always helpful for patients in many aspects, it seems inarguable that HALS, a bridge between laparoscopic and open surgery, is one of the useful surgical techniques in urology
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