Laparoscopic distal pancreatectomy with possible splenectomy [case 14]

OR Footage

Summary of surgeons' findings and slowing down moments:

Operating surgeon

• Dr. Cleary's Procedure-specific moments:
1. Mobilization of pancreas
2. Possible splenic preservation
3. Dissection of splenic vessels
4. Division at neck of pancreas
5. Dissection of pancreatic tail at splenic hilum
• Critical imaging findings:
1. Cystic nature of lesion
2. Tumor proximity to splenic vein
3. Tumor proximity to left adrenal gland
4. Posterior pancreas margin: Gerota's fascia
5. Anterior pancreas margin: posterior wall of stomach

Consulting surgeon

• Dr. Moulton's procedure-specific moments:
1. Tumor proximity to portal vein, tunnel behind neck of pancreas
2. Tumor proximity to splenic vein and splenic artery
3. Possible splenic preservation
4. Retroperitoneal dissection
• Patient imaging findings:
1. No formal tunnel dissection required
2. Normal ligation of splenic vein and splenic artery
3. Warshaw technique for splenic preservation
4. Tumor proximity to left adrenal gland

Watch the following videos from the operation to see some of the key moments in the case.