eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2020
vol. 15
 
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abstract:
Review paper

Tips and tricks for a safe laparoscopic pancreatoduodenectomy

Ioannis Triantafyllidis
1
,
Brice Gayet
2
,
David Fuks
2

  1. Department of General Surgery, Konstantopoulio-Patision Hospital of Nea Ionia, Athens, Greece
  2. 2 Department of Digestive Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France
Videosurgery Miniinv 2020; 15 (3): 383–390
Online publish date: 2020/08/17
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Minimally invasive pancreatoduodenectomy has been revolutionized during the last decades and, although not as rapidly or widely adopted, the laparoscopic approach seems to be feasible with various potential advantages compared to traditional open pancreatoduodenectomy. Laparoscopic pancreatoduodenectomy is a technically demanding procedure with a steep learning curve mainly due to the fact that the technique is not standardized. Technical details as well as tips and tricks of the operation are described. Standardization of the procedure is the cornerstone of the learning curve of minimally invasive pancreatoduodenectomy. One of the largest barriers of this complex procedure is the reconstruction phase with the creation of three separate anastomoses. A hybrid approach may help surgeons – especially during the initial phase of the learning curve – to overcome the difficulties associated with a fully laparoscopic reconstruction, while retaining the advantages of laparoscopy.
keywords:

laparoscopic pancreatoduodenectomy, superior mesenteric artery, pancreatic adenocarcinoma, Whipple procedure, portal vein

  
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