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Laparoscopic duodenopancreatectomy

Marco Marino, Gaspare Gulotta, Andrzej L Komorowski
Robotic surgery can help to overcome some technical limitations of laparoscopic pancreaticoduodenectomy thanks to EndoWrist instrumentations and the 3D view. Despite the potential benefits, its employment is still low and controversial. We focused on some important technical details crucial for a safe robotic pancreatectomy. After performing 52 robotic pancreatic resections that included 10 pancreatoduodenectomies, the authors describe their technique. The review of literature on robotic and laparoscopic duodenopancreatectomy is also performed in order to evaluate possible benefits of the robotic platform...
April 2018: Indian Journal of Surgery
Diogo Turiani Hourneaux De Moura, Martin Coronel, Igor Braga Ribeiro, Galileu Ferreira Ayala Farias, Maria Auxiliadora Choez, Rodrigo Rocha, Marcello Pecoraro Toscano, Eduardo Guimarães Hourneaux De Moura
BACKGROUND: Solid pseudopapillary tumor of the pancreas, otherwise known as solid and cystic tumor or Frantz tumor, is an unusual form of pancreatic carcinoma, with unknown etiopathogenesis, that accounts for 0.2 to 2.7% of all pancreatic tumors. It is defined as an exocrine pancreatic neoplasia that mainly affects women between the second and third decade of life, and its management is not well defined. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound fine-needle aspiration has become the gold standard method for the diagnosis of pancreatic lesions...
April 26, 2018: Journal of Medical Case Reports
Mingjun Wang, He Cai, Lingwei Meng, Yunqiang Cai, Xin Wang, Yongbin Li, Bing Peng
BACKGROUND: While an increasing number of open procedures are now routinely performed laparoscopically or robotically, minimally invasive pancreaticoduodenectomy (MIPD) remains one of the most challenging operations in abdomen. The aim of this study is to evaluate the current status and development of MIPD. METHODS: Embase, Medline, and PubMed databases were searched to identify studies up to and including Feb 2016 using the keywords "laparoscopic", or "laparoscopy", or "hand-assisted", or "minimally invasive", or "robotic", or "da vinci" combined with "pancreaticoduodenectomy", or "duodenopancreatectomy", "Whipple", or "pancreatic resection"...
November 2016: International Journal of Surgery
Erik Schlöricke, Martin Hoffmann, Peter Kujath, Ganesh M Shetty, Fabian Scheer, Marc O Liedke, Markus Zimmermann
BACKGROUND: In contrast to laparoscopic left pancreatic resection, laparoscopic total duodenopancreatectomy is a procedure that has not been standardized until now. It is not only the complexity that limits such a procedure but also its rare indication. The following article demonstrates the technical aspects of laparoscopic pylorus- and spleen-preserving duodenopancreatectomy. CASE REPORT: The indication for intervention in the underlying case was a patient diagnosed with a multiple endocrine neoplasia (MEN) I syndrome and a multifocal neuroendocrine tumor (NET) infiltrating the duodenum and the pancreas...
October 2015: Viszeralmedizin
Patrick Pessaux, Michele Diana, Luc Soler, Tullio Piardi, Didier Mutter, Jacques Marescaux
BACKGROUND: The minimally invasive surgeon cannot use 'sense of touch' to orientate surgical resection, identifying important structures (vessels, tumors, etc.) by manual palpation. Robotic research has provided technology to facilitate laparoscopic surgery; however, robotics has yet to solve the lack of tactile feedback inherent to keyhole surgery. Misinterpretation of the vascular supply and tumor location may increase the risk of intraoperative bleeding and worsen dissection with positive resection margins...
August 2014: Surgical Endoscopy
Frédéric Borie, Alban Zarzavadjian Le Bian
Lesions involving the ampulla of Vater are rare entities (0.1-0.2 %) with high malignant potential (90 %) [1]. As a treatment, the surgical procedure known as duodenopancreatectomy was the main option, whatever the tumor's stage or nature. Yet with improvements of endoscopic diagnostic and therapeutic techniques, management of these lesions has been modified, enabling endoscopic removal of adenoma and adenocarcinoma-in situ. Thus, when endoscopic treatment is not possible, surgical ampullectomy is still an alternative option to duodenopancreatectomy [1, 2]...
November 2013: Surgical Endoscopy
Andrew A Gumbs, Roland Croner, Angel Rodriguez, Noah Zuker, Aristoteles Perrakis, Brice Gayet
INTRODUCTION: Because of the potential benefit of robotics in pancreatic surgery, we review our experience at two minimally invasive pancreatic surgery centers that utilize a robotically controlled laparoscope holder to see if smaller robots that enable the operating surgeon to maintain contact with the patient may have a role in the treatment of pancreatic disease. METHODS: From March 1994 to June 2011, a total of 200 laparoscopic pancreatic procedures utilizing a robotically controlled laparoscope holder were performed...
October 2013: Surgical Endoscopy
Elena Orsenigo, Saverio Di Palo, Valentina Tomajer, Carlo Staudacher
We report the case of a 40-year-old male patient who presented with melaena and acute anaemia. Endoscopic ultrasound examination revealed a lesion with a central depression measuring 2.5 cm, arising from the lateral wall of the second portion of the duodenum. Because of this rare location, a very invasive procedure (duodenopancreatectomy) might have been required for tumour resection. We avoided this operation and implemented an alternative solution. A laparoscopic wedge resection of the duodenal tumour was successfully completed...
May 2008: Chirurgia Italiana
Fernando Rotellar, Fernando Pardo, Custodia Montiel, Alberto Benito, Fernando M Regueira, Ignacio Poveda, Pablo Martí-Cruchaga, Javier A Cienfuegos
OBJECTIVE: To present the results of a series of laparoscopic middle pancreatectomies with roux-en-Y duct-to-mucosa pancreaticojejunostomy. SUMMARY OF BACKGROUND DATA: Middle pancreatectomy makes it possible to preserve pancreatic parenchyma in the resection of lesions that traditionally have been treated by distal splenopancreatectomy or cephalic duodenopancreatectomy. The laparoscopic approach could minimize the invasiveness of the procedure and enhance the benefits of middle pancreatectomy...
June 2008: Annals of Surgery
M Fähndrich, M Sandmann, M Heike
Endoscopic retrograde cholangiography (ERC) after Roux-en-Y reconstruction and modified BII surgery or duodenopancreatectomy is considerably more difficult than ERC under normal anatomic conditions. If the common bile in the afferent loop cannot be reached by a common lateral-viewing duodenoscope because of excessive intestinal length, it has recently become possible to use double balloon enteroscopy (DBE) for ERC to reach the common bile duct. Cannulating the bile duct via DBE in these postoperative settings remains one of the most difficult ERCP manipulations because of the lack of an Albarran lever and the use of extra long ERCP accessories...
April 2008: Zeitschrift Für Gastroenterologie
Mario Testini, Giuseppe Piccinni, Germana Lissidini, Beatrice Di Venere, Angela Gurrado, Elisabetta Poli, Nicola Brienza, Antonio Biondi, Luigi Greco, Michele Nacchiero
AIM: To report our experience of managing patients affected by descending duodenal injuries secondary to laparoscopic cholecystectomy and to review the literature. METHODS: Analysis of 5 cases of descending duodenal injury as a consequence of laparoscopic cholecystectomy managed between June 1992 and September 2006. RESULTS: The median age was 59 (range 49-67) years. In all cases an emergency laparotomy showed an injury to the descending duodenum...
2008: Digestive Surgery
Andrew A Gumbs, Brice Gayet
No abstract text is available yet for this article.
February 2008: Surgical Endoscopy
Andrew A Gumbs, Philippe Grès, Fabio A Madureira, Brice Gayet
Required resection margins for noninvasive intraductal papillary mucinous neoplasms (IPMNs) are a controversial issue. Over a 10-year period we have resected IPMNs from the entire pancreatic gland with minimally invasive techniques and compared our survival and complication rates with open controls to see if any difference in resection margins and outcomes could be observed. Data were collected retrospectively, including our first cases of advanced laparoscopic resections. Five-year Kaplan-Meier curves were calculated and statistical analysis was performed using the log rank and Student's T test for continuous variables...
April 2008: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
I Gockel, K Oberholzer, C Corinth, J K Seifert, T H Junginger
HISTORY AND ADMISSION FINDINGS: A 61-year-old man had been suffering from repeated episodes of postprandial vomiting and a feeling of fullness as well as a weight loss of 8 kg for two months. Three years prior to this, a laparoscopic cholecystectomy had been carried out at a different institution after a pancreatitis on the assumption of a biliary genesis. There were no sings of jaundice or gastro-intestinal bleeding. The physical examination was -- apart from epigastric pain -- unremarkable...
July 8, 2005: Deutsche Medizinische Wochenschrift
C Staudacher, E Orsenigo, P Baccari, S Di Palo, S Crippa
BACKGROUND: In the past few years, minimally invasive therapy for pancreatic diseases has made significant strides but the role of laparoscopic pancreaticoduodenectomy is still controversial. METHODS: Four patients with a mean age of 44 +/- 11 years were chosen for a laparoscopic pancreaticoduodenectomy. Pathological diagnoses were ductal adenocarcinoma in one, neuroendocrine tumor in two, and metastatic malignant melanoma in one. RESULTS: The procedure was laparoscopically completed in all with a mean operating time, blood loss, and hospital stay of 416 +/- 77 min, 325 +/- 50 ml, and 12 +/- 2 days, respectively...
March 2005: Surgical Endoscopy
P Smejkal, M Smejkal
The authors discuss, based on a case-report, the diagnostic problems of malignities of the pancreas and ampulla of Vater. In the same patient they found an interesting complication after laparoscopic cholecystectomy (LCHE). It was a female patient who had LCHE four years previously where an ampulloma of the ampulla of Vater was diagnosed with invasion into the pancreas and a suspect secondary in the lower lobe of the right lung. On operation a pulmonary abscess was detected from a retained concrement. Duodenopancreatectomy which was performed did not reveal any tumour in the pancreatic area...
January 2002: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
M V Danilov, V S Pomelov, B A Vishnevskiĭ, I M Buriev, A V Vikhorev, P O Kazanchian, T V Savvina
During 1975-88 the staff of the Vishnevskiĭ+ Institute of Surgery performed 95 pancreatoduodenal resections (PDR) and 23 total duodenopancreatectomies (TDPE) in malignant tumors of the head of the pancreas (49), major duodenal papilla (30), terminal choledochus (12), duodenum (12), and in 15 patients with chronic pancreatitis. In 13 cases PDR and TDPE were undertaken as a second operation after creation of biliodigestive anastomoses: after laparoscopic cholecystostomy in 24 and after various abdominal operations in 20 cases...
October 1990: Khirurgiia
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