Laparoscopic Pancreas Resection
April 22, 2009 § Leave a comment
Cutting through the serosa of the pancreas.
Two videos I’ve made of surgery for pancreatic cancer was published on www.oncolex.org last week. The first one is a laparoscopic resection of the tail of pancreas. The patient in question has a tumor in the distal part of the tail of pancreas, together with several splenic infarctions. In this operation the tail of pancreas and the spleen is going to be removed en bloc.
The left colic flexure is taken down and the omental bursa is opened. Several varicose short gastric veins are visible between the liver and pancreas.
The splenic artery is identified and dissected above the pancreas, and the splenic vein below it. An endoscopic ultrasound probe is used to confirm that the area of the pancreas they want to cut through is tumor free. Both splenic vessels are then cut using an EndoGIA stapler. The pancreas is cut with a larger versio of the EndoGIA.
The varicose short gastric veins are then cut with several stapler magazines and the spleen is dissected from the diaphragm. There is a lot of inflammatory adhesions between the stomach and the spleen. These are carefully dissected and the stomach and spleen is separated. The specimen, consisting of the spleen and tail of pancreas is put in an endobag and removed via an umbilical incision. The remaining pancreas is covered with a surgical patch.
The final picture shows the specimen cut open with a yellowish tumor inside.
The Sterile Eye 
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