C Palanivelu, P Senthilnathan, P Praveen Raj, P S Rajan, S Rajapandian, V Vaithiswaran, S Gobu. GEM Hospital & Research Centre
Introduction
As innovation continues to move 21st century surgery forward, one of the emerging concepts is single-port or single-incision laparoscopic surgery. The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. The major drawback to such a surgical approach is that the concept of ‘‘triangulation’’ to which laparoscopic surgeons have grown accustomed in terms of both the instruments and scope is lacking. This, however, seems to be overshadowed by the increasing acceptability of in-line viewing, with the re emphasis on surgeons performing flexible endoscopy and on newer ideas such as natural orifice translumenal endoscopic surgery
Methods
This video describes the step by step approach of single incision mullti port technique using conventional laparoscopic instruments for distal pancreatectomy.
Step1. Incision and flap rising
Step 2: Placement of ports
Step 3 : Opening of gastro colic omentum and exposure of pancreas with Suture retraction of stomach
Step 4 : Mobilization of the pancreas , attempt to preserve the splenic artery and vein was made by clip ligation of the pancreatic branches of the splenic vessels , then the transection of pancreas was done using harmonic and stump closed with 2-0 PDS sutures
Step 5 : Specimen extraction done in endobag through the same incision
Conclusion
Single port spleen preserving distal pancreatectomy is safe and viable in experienced hands and can be done with conventional instruments.
Session Number: VidTV1 – Video Channel Rotation Day 1
Program Number: V084