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Single‐incision laparoscopic distal pancreatectomy with or without splenic preservation: How we do it
Author(s) -
Misawa Takeyuki,
Ito Ryusuke,
Futagawa Yasuro,
Fujiwara Yuki,
Kitamura Hiroaki,
Tsutsui Nobuhiro,
Shiba Hiroaki,
Wakiyama Shigeki,
Ishida Yuichi,
Yanaga Katsuhiko
Publication year - 2012
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/j.1758-5910.2012.00155.x
Subject(s) - medicine , surgery , retractor , forceps , distal pancreatectomy , laparotomy , laparoscopic surgery , pancreatectomy , pancreas , port (circuit theory) , laparoscopy , general surgery , resection , engineering , electrical engineering , endocrinology
Abstract Introduction Recent interest in improving cosmetic outcomes has led to single‐incision laparoscopic surgery ( SILS ) being performed in a variety of organs. However, this innovative technique has rarely been introduced in pancreatic surgery, as it is considered to be a challenging procedure. We report herein our technique of single‐incision laparoscopic distal pancreatectomy with or without splenic preservation. Materials and Surgical Technique A 2.5‐cm intraumbilical mini‐laparotomy was made for the placement of a SILS Port as a single access site. The overall procedures were similar to those performed in the standard laparoscopic distal pancreatectomy with multiple trocars. To obtain better exposure of the operative field, we made technical refinements by employing gastric suspension with sutures, the tug‐exposure technique, a balloon retractor, and gravity by changing the patient's position. The pancreas was transected with a linear stapler, and the specimen was extracted through the umbilical wound. Discussion Patients were discharged without any complications. The umbilical wounds were almost invisible 1 month after surgery. We believe that SILS , with some technical refinements, can be safely applied for distal pancreatectomy. Although the cosmetic benefits of single‐incision laparoscopic distal pancreatectomy are obvious, several issues such as the extent of invasiveness, cost, indications, and learning curve need to be investigated.