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Updated: Sep 30, 2025
Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy
Published on: May 5, 2023
Self-traction Method for Uncinate Process Dissection During Laparoscopic Pancreaticoduodenectomy
Sung Hoon Choi1, Eui Hyuk Chong2, Jae Young Jang2
1Division of Hepatobiliary and Pancreas, Department of Surgery, CHA Bundang Medical Center, CHA University, Cancer Research Building #524, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea. feel415@cha.ac.kr.
A novel self-traction technique using a nylon tape and rubber band simplifies laparoscopic pancreaticoduodenectomy by improving visualization during uncinate process dissection. This method enhances operative field exposure and stability for oncologic resection.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic pancreaticoduodenectomy presents challenges, particularly in uncinate process dissection.
- Securing the retroperitoneal resection margin is critical for oncologic outcomes.
Purpose of the Study:
- To introduce a novel self-traction method for laparoscopic uncinate process dissection.
- To improve visualization and access to the retroperitoneal resection margin.
Main Methods:
- A 25-cm nylon tape encircled the pancreatic head and duodenal unit.
- An elastic rubber band provided automatic, gradual self-traction.
- This technique freed both surgeon's hands during dissection.
Main Results:
- The self-traction method provided stable lateral traction of the uncinate process.
- Improved visualization of the retroperitoneal margin between the uncinate process and SMA was achieved.
- Demonstrated effective application for achieving a proper operative field.
Conclusions:
- The simple traction method enhances operative field exposure.
- It provides a stable surgical environment for uncinate process dissection.
- Facilitates improved oncologic safety in laparoscopic pancreaticoduodenectomy.
