Hand-assisted staging laparoscopy for suspected malignancies of the pancreas

Fewer than 20% of patients with pancreatic cancer have resectable tumours at the time of diagnosis. In two patients with a pancreas neoplasm a laparoscopic staging work-up was performed. Because of the described limitations of laparoscopy, we propose to switch to a hand-assisted procedure. In our opinion the benefits of hand-assisted laparoscopic surgery, such as safe blunt digital dissection, restoration of tactile feedback and restored proprioception, account for greater accuracy in TNM staging and in the assessment of resectability of pancreatic cancer.