• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Distal pancreatectomy under Water-Filled Laparo-Endoscopic Surgery to confirm minimal invasiveness

Hiroshi Kawahira, MD, PhD1, Tatsuo Igarashi, MD, PhD1, Takuro Ishii, PhD1, Ryoichi Nakamura, PhD1, Yukio Naya, MD, PhD2. 1Center for Frontier Medical Engineering, Chiba University, 2Department of Urology, Teikyo University Chiba Medical Center

Objective of the technology or device

The pancreas is located in the retroperitoneal cavity and adheres to the spleen which controls the amount of blood flow. From these anatomical aspects, distal pancreatectomy requires a relatively wide range of incision. Although 1435 patients underwent laparoscopic distal pancreatectomy by 2013 in Japan, laparoscopic distal pancreatectomy has not been as common as laparoscopic surgery for other organs such as the colon, rectum or stomach. The number of laparoscopic distal pancreatectomy has been limited yet. Therefore, we conducted an initial study, using a swine, of distal pancreatectomy with a small incision and Water-Filled Laparo-Endoscopic Surgery, and report possibilities of this as minimally invasive surgery.

 

Description of the technology and method of its use or application

This experiment was approved by the ethical committee for animal experiments at Chiba University. Under general anesthesia, a male swine weighed 30kg was laid in the right 45-degree semi recumbent position on the operating table and ultra sound was performed to identify the distal part of the pancreas. 5cm vertical incision was made on the lateral abdomen and a retractor was put to retract the great omentum and small intestine. A 5mm trocar was inserted from the caudal part of the incision and Karl Storz Image 1HD laparoscopy (Karl Storz Japan, Inc. Tokyo, Japan) was used for examination. Sonicision (Covidien Japan, Inc. Tokyo, Japan) was used as an ultrasonic coagulating shears and for transection of the pancreatic body. A bipolar electrocautery (Kobayashi Medical, Osaka, Japan) was used for coagulation.

 

Preliminary results if available

The greater omentum was cut open from a small incision to enter the omental bursa and the anterior surface of the pancreas tail could been observed directly and laparoscopically. The pancreatic fascia was dissected using Sonicision by identifying the splenic artery and the splenic vein. The pancreatic body was transected by Sonicision. Minor hemorrhage was coagulated by a bipolar electric scalpel. Cavitation made by the Sonicision was a concern at first. The direct and laparoscopic view was blocked for an instant by jet bubble, but the view returned immediately. There is no effect on the procedure progress. After transecting the pancreas, damage was given to the root of the inferior mesenteric vein (IMV) which flowed into the splenic vein, and there was bleeding that required hemostasis. The pancreatic tail was resected, and the procedure was finished because the swine went into cardiac arrest.

 

Conclusions / future directions

In this study, DP under the WaFLES environment was performed using a swine. The surgery was not completed successfully because IMV was damaged and the swine went into cardiac arrest, but we managed to transect the pancreas.  It has been thought that the use of ultrasonic coagulating shears in water has difficulty in securing a field of vision, but our experiment this time showed that the use did not have any problem. This is a preliminary result of our first distal pancreatectomy by WaFLES procedure. We will pursue possibilities of distal pancreatectomy for minimal invasiveness.

44

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2015 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons