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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2019
vol. 14
 
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abstract:
Original paper

Retroperitoneoscopic distal pancreatectomy: a new surgical approach

Long-Zhi Zheng
1
,
Guo-Wei Lin
2
,
Chang-Yue Zheng
1
,
Jian Guo
1
,
Bin Zu
1
,
Jian-Xin Huang
3
,
Wei Lin
1

  1. Department of Gastrointestinal Surgery and Gastrointestinal Surgery Research Institute, the Affiliated Hospital of Putian University, Putian, China
  2. Department of Urinary Surgery, the Affiliated Hospital of Putian University, Putian, China
  3. Department of Ultrasonography, the Affiliated Hospital of Putian University, Putian, China
Videosurgery Miniinv 2019; 14 (3): 374–380
DOI: https://doi.org/10.5114/wiitm.2019.81442
Online publish date: 2019/01/22
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Introduction
The traditional laparoscopic surgery is difficult to deal with the deep lesions of the body and tail of the pancreas, which may damage the visceral organs of the abdominal cavity and cause abdominal adhesion and other related complications.

Aim
This paper introduces the operation procedure of retroperitoneoscopy in pancreatic surgery, and evaluates its feasibility in clinical application.

Material and methods
Retrospective analysis was performed on patients with retroperitoneal pancreatectomy in our hospital. The anatomical features of the fascia, surgical plane composition and surgical pathway of the fascia of the retroperitoneoscopic pancreatectomy were observed during the operation, and the surgical safety and feasibility were analyzed. The following parameters were evaluated: operation time, blood loss, pancreatic fistula, postoperative gastro-intestinal recovery, hospital stay.

Results
All 3 patients had a smooth operation and no serious complications occurred. During retroperitoneal laparoscopic pancreatectomy, there is a vascularized plane between the posterior fascia of the pancreas and the prerenal fascia, which can avoid injury of the visceral organs and retroperitoneal vessels. The anterior renal fascia should be used as the posterior boundary of the safe separation plane.

Conclusions
The surgical plane based on the anatomy of the fascia and interstitial dissection is the theoretical basis of modern surgery, which is safe, fast and effective. The inter-prerenal fascia plane is the correct and safe anatomical plane of posterior laparoscopic surgery.

keywords:

pancreas, retroperitoneoscopy, inter-prerenal-fascia planes, Toldt’s fascia
  
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