plex celiac neurolysis laparoscopically in patients with advanced pancreatic cancer and gastric, description of the technique

Uriel Cardona, DO¹, Mauricio Zuluaga Zuluaga, DO², Ivo Siljic, DO², Juan Valencia, DO¹. ¹SALUDCOOP CLINICA, ²HOSPITAL UNIVERSITARIO DEL VALLE

BACKGROUND Patients with advanced gastrointestinal cancer are difficult management and therapeutic choices are limited, celiac neurolysis complex is offered as an option for pain control for these patients.

METHODS Is described below the laparoscopic technique neurolysis of the celiac plexus. Patient is placed in French position, the surgeon is located between the patient's legs and the assistant on the right. The 10 mm umbilical trocar is placed, another 10 mm trocar in the right flank, and a 5 mm trocar in the left flank. Diagnostic laparoscopy is performed, the lesser curvature of the stomach is identified, the left gastric artery emerging from the celiac trunk. A pericranial catheter 22 is inserted through the trocar of 10 mm on the right flank and 20 ml of alcohol 95% (1/2) is instilled on each side of the emergence of the celiac trunk, verifying that it is not performing an arterial puncture. Removal is done under direct vision of the catheter and the procedure ends.

CONCLUSIONS Neurolysis of the celiac plex laparoscopically is an easy, cheap and safe technique, and is offered as an alternative for palliative management of patients with advanced gastrointestinal cancer.