Attaching esophageal & gastric tube
Attaching the esophageal and gastric tube prior to mobilization.
The Pylorus
The pylorus is viewed from the gastric antrum. The endoscope is gently advanced while keeping the pylorus directly in the center of the visual field. Sometimes the pylorus will be observed to open and close. Position the endoscope ready to pass through th
Lateral traction on the splenogastric attachments
Once the lesser sac has been entered, lateral traction on the splenogastric attachments will allow exposure of the short gastric vessels. These can be clipped (as shown) or divided with the LCS. (Reprinted with permission from Salky BA, Edye M. Laparoscop
Trocar Placement
Trocar placements for distal pancreatectomy. These sites are proper for both splenic salvage and with splenectomy. There should be at least a hand’s breadth distance between trocars 1, 3, and 4. The trocar for the laparoscope should be above the umbilicus