Laparoscopic spleno-pancreatectomy for cancer
Epublication WebSurg.com, Dec 2006;06(12). URL: http://websurg.com/doi/vd01en2037
Laparoscopic spleno-pancreatic resection performed for adenocarcinoma in the tail of the pancreas. This case demonstrates how a complex resection can be undertaken laparoscopically using a stepwise approach. Difficulty was encountered with division of the pancreas and the management of this problem is discussed. The surgeon stands between the patient's legs with the table in the reverse Trendelenburg position. The authors place three 10-mm ports across the upper abdomen with additional 5-mm ports in the left subcostal epigastric area. The camera is placed in the supraumbilical port. The laparascopic approach provides superior visualization, and tactile assessment of the pancreas. Mobility of the tumor is important to determine feasibility of resection. Laparoscopic ultrasound can delineate the tumor and surrounding structures.