Laparoscopic Pylorus Preserving Pancreaticoduodenectomy

Abstract

Abstract Introduction: Minimally invasive pancreaticoduodenectomy, first described by Gagner and Pomp in 1994,1 has made a significant progression in the past few years due to the evolution in surgical techniques and advancement in instrumentation. Multiple publications have touted its feasibility and our group has shown its safety in comparison to open pancreaticoduodenectomy.2 This 15-minute video demonstrates our current technique of laparoscopic pancreaticoduodenectomy with patient and surgeon positioning and trocar placement. Surgeon positioning, camera placement, and trocar use will vary throughout each step of the procedure and these variations are demonstrated. Materials and Methods: A 61-year-old male presented with painless jaundice and imaging revealed a mass in the head of the pancreas. He was taken for a totally laparoscopic pancreaticoduodenectomy. The patient is positioned in a supine split leg position and six trocars are placed. The operation starts by entering the lesser sac and exposing...