Laparoscopic Left Side Duodenum Adenocarcinoma Resection (III-IV Segment): A Step-By-Step Surgical Technique

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Background:

• Nonampullary duodenal adenocarcinoma (NDA) is a rare gastrointestinal cancer, comprising about 5% of all cases.
• Complete surgical resection (R0) with lymph node removal is essential for potentially curative treatment and long-term survival in NDA.
• Minimally invasive surgery has demonstrated safety and oncological equivalence in pancreaticoduodenectomy for similar cancers.

Purpose of the Study:

• To describe a fully laparoscopic approach for complete resection of left-sided nonampullary duodenal adenocarcinoma.
• To detail the surgical technique, emphasizing the critical view of safety and intracorporeal anastomosis.
• To provide a guide for surgeons undertaking this complex minimally invasive procedure.

Main Methods:

• A fully laparoscopic technique for left-sided duodenal adenocarcinoma (segments III-IV) resection was performed.
• The procedure included locoregional lymph node resection.
• Intracorporeal anastomosis was utilized for reconstruction of intestinal continuity.

Main Results:

• This paper details the first reported fully laparoscopic complete resection (R0) of left-sided duodenal adenocarcinoma (segments III-IV) with lymph node removal.
• The critical view of safety was employed throughout the procedure.
• Successful reconstruction was achieved via intracorporeal anastomosis.

Conclusions:

• The described fully laparoscopic approach offers a viable minimally invasive option for left-sided nonampullary duodenal adenocarcinoma.
• This technique facilitates complete tumor resection and lymph node dissection.
• The study aims to enhance surgeon familiarity and proficiency with this complex procedure.