Endoscopic total retroperitoneal distal pancreatectomy in a large animal model

Traditionally, distal pancreatic lesions are resected by the open technique. An ever-increasing number of laparoscopic transperitoneal distal pancreatectomy cases are being reported. This study explores the possibility of performing distal pancreatectomy via an endoscopic retroperitoneal approach. This study was done in two stages using a total of 15 pigs: the first stage involved dissection in euthanized pigs, and the second stage involved anesthetized pigs. In both stages of the study, distal pancreatectomy could be performed within an acceptable time frame and with acceptable resection margins and morbidity rate. We introduce the concept of endoscopic total retroperitoneal distal pancreatectomy as an approach for distal pancreatectomy.