Tips and tricks for a safe laparoscopic pancreatoduodenectomy

Area of Science:

• Minimally invasive surgery
• Surgical oncology
• Gastrointestinal surgery

Background:

• Minimally invasive pancreatoduodenectomy (MIPD) has evolved, with laparoscopy showing promise over open procedures.
• Laparoscopic pancreatoduodenectomy (LPD) is complex, demanding a high level of surgical skill and a standardized technique.
• The procedure's steep learning curve is a significant barrier to widespread adoption.

Purpose of the Study:

• To describe the technical details, tips, and tricks for performing laparoscopic pancreatoduodenectomy.
• To highlight the importance of standardization in mastering the learning curve for MIPD.
• To present a hybrid approach as a strategy to facilitate laparoscopic reconstruction.

Main Methods:

• Detailed description of the laparoscopic pancreatoduodenectomy technique.
• Emphasis on standardization of surgical steps.
• Introduction of a hybrid approach combining laparoscopic and open techniques for reconstruction.

Main Results:

• Laparoscopic pancreatoduodenectomy is feasible and offers potential advantages.
• The reconstruction phase, involving three anastomoses, is a major technical challenge.
• A hybrid approach can mitigate difficulties during the initial learning phase.

Conclusions:

• Standardization is crucial for overcoming the learning curve in minimally invasive pancreatoduodenectomy.
• The hybrid approach offers a viable solution for surgeons navigating the complexities of laparoscopic reconstruction.
• This strategy aims to retain laparoscopic benefits while managing surgical challenges.