Abstract
Recent interest in improved cosmetic outcomes has led to application of single-incision laparoscopic surgery (SLS) to a variety of organs. However, this innovative technique has been applied only rarely to pancreatic surgery, and, it is regarded as quite challenging. In this chapter, we describe techniques we use to perform single-incision laparoscopic distal pancreatectomy (DP) with or without splenic preservation. A 2.5-cm intra-umbilical mini-laparotomy is made for placement of a SILS™ Port (Covidien, New Haven, CT, USA) as a single access site. The overall procedure is similar to that of standard laparoscopic DP with multiple trocars. To obtain adequate exposure of the operative field, we applied suture suspension of the greater curvature of the stomach, the tug-exposure technique, a balloon retractor, and the use of gravity by changing the patient’s position. The pancreas is transected with a linear stapler, and the specimen is extracted through the umbilical wound. The resulting umbilical scar is nearly invisible by 1 month after surgery. We conclude that SLS can be safely applied to DP if specific technical refinements are implemented. Although the cosmetic benefit of single-incision laparoscopic DP is clear, several issues, including the extent of invasiveness, the costs, the indications, and the learning curve, remain to be investigated.
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© 2014 Springer Japan
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Misawa, T. (2014). Distal Pancreatectomy. In: Mori, T., Dapri, G. (eds) Reduced Port Laparoscopic Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54601-6_23
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DOI: https://doi.org/10.1007/978-4-431-54601-6_23
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