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Laparoscopic Radical Left Pancreatectomy for Pancreatic Cancer: Surgical Strategy and Technique Video
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Totally laparoscopic stapled distal pancreatectomy.

Hirokatsu Katagiri1, Akira Sasaki, Hiroyuki Nitta

  • 1Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. hkataji@live.jp

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|July 14, 2012
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Summary

Totally laparoscopic distal pancreatectomy (LDP) using a stapler and TachoComb sealant reduced pancreatic fistula rates. This combined technique offers improved outcomes compared to stapling alone for LDP.

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Area of Science:

  • Minimally Invasive Surgery
  • Gastrointestinal Surgery
  • Surgical Innovation

Background:

  • Distal pancreatectomy is a common procedure for pancreatic diseases.
  • Minimally invasive approaches like LDP aim to reduce patient morbidity.
  • Effective management of the pancreatic stump is crucial to prevent complications.

Purpose of the Study:

  • To evaluate the outcomes of totally laparoscopic distal pancreatectomy (LDP).
  • To assess the efficacy of using a stapler combined with TachoComb for pancreatic stump closure in LDP.

Main Methods:

  • A retrospective analysis of 15 patients undergoing LDP between March 2003 and January 2010.
  • Pancreatic transection was performed using a stapler.
  • The pancreatic stump was sealed with fibrin-coated collagen fleece (TachoComb).

Main Results:

  • LDP was successfully completed in all 15 patients with median operative time of 168 minutes and median blood loss of 36 ml.
  • Biochemical pancreatic leaks occurred in 20% of patients, with no reported clinical fistulas or postoperative hemorrhage.
  • Median hospital stay was 7 days, with decreasing drain amylase levels postoperatively.

Conclusions:

  • The combination of a stapler and TachoComb significantly decreased pancreatic fistula incidence after LDP.
  • This technique provides more efficient and consistent results compared to stapling alone.
  • LDP with TachoComb sealant is a safe and effective method for managing the pancreatic stump.