Laparoscopic distal pancreatectomy
Epublication WebSurg.com, Jun 2016;16(06). URL: http://websurg.com/doi/lt03enasbun004
Almost all lesions smaller than 7cm, which do not involve the coeliac or mesenteric vessels, should be considered for laparoscopic distal pancreatectomy. Several meta-analyses showed the clear benefits of laparoscopic distal pancreatectomy over open surgery regarding blood loss, hospital stay, morbidity, and wound infection. The comparison of open surgery vs. laparoscopic surgery in patients presenting with adenocarcinoma shows the benefits of laparoscopic surgery. It is much easier to learn this technique. In this lecture, the clockwise technique is briefly demonstrated. Gravity, ports position and instrumentation are essential. The key steps of the clockwise technique are as follows: mobilization of the splenic flexure and of the proximal descending colon, dissection from lateral to medial along the lower edge of the pancreas, determination of the point of division (stapled or hand-sewn), posterior dissection, mobilization of the spleen using gravity along the superior edge of the pancreas, and removal of the specimen.