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Distal pancreatectomy (body and tail)


  • The first trocar (12 mm) is placed in the umbilicus. A total of 4 ports are routinely used. The last three are placed through the abdominal wall in an arc around the area of the tumor.
  • The left colon flexur is mobilized medially and the omental bursa is opened to expose the anterior distal end of the pancreas. For sufficient exposure, the stomach is mobilized medially and the transverse colon caudally, in order for the short gastric vessels between the speen and stomach as well as the gastrocolic ligament to be divided. 
  • Peroperative ultrasound is used to precisely localize the tumor.
  • The splenic artery and vein are dissected from the pancreas proximal to the tumor. The vessels are dissected to the origin of the splenic artery. The vessels are then split with a linear vessel stapler (artery before vein). In cases where the tumor invades toward neighboring organs - if there are no other contraindications - an èn-bloc resection of the infiltrated organs (adrenal gland, kidney, partial resection of colon and stomach) can be performed.
  • After resection the specimen is placed in an endocatch bag and pulled out in an extended umbilical incision.
  • Finally, a drain is installed near the incision on the pancreas, before closing the abdomen.

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