Single-Port Laparoscopic Spleen Preserving Distal Pancreatectomy

Single-port laparoscopic surgery has become increasingly popular, with widened indication to more types of surgery. This report will present our initial experience with spleen-preserving distal pancreatectomy technique through a small transumbilical incision using the single-port approach for a cystic tumor of pancreatic body. The surgery was done using specialized single-port instruments and normal laparoscopic instruments. The total operative time for this surgery is 233 minutes, and it was completed without drains. Patient was discharged from the hospital on the third day postoperatively in good condition.

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FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.4.15 ◽

2016 ◽

pp. 99-105

Author(s):

Huu Tri Nguyen ◽

Loc Le ◽

Doàn Van Phu Nguyen ◽

Nhu Thanh Dang ◽

Thanh Phuc Nguyen

Keyword(s):

Duodenal Ulcer ◽

Laparoscopic Surgery ◽

Correlation Coefficient ◽

Open Surgery ◽

Operative Time ◽

Single Port ◽

Time Correlation ◽

Patch Repair ◽

Perforated Duodenal Ulcer ◽

Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

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Securing the surgical field for mobilization of right-sided colon cancer using the duodenum-first multidirectional approach in laparoscopic surgery

Techniques in Coloproctology ◽

10.1007/s10151-021-02444-5 ◽

2021 ◽

Author(s):

K. Nagayoshi ◽

S. Nagai ◽

K. P. Zaguirre ◽

K. Hisano ◽

M. Sada ◽

...

Keyword(s):

Colon Cancer ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Blood Loss ◽

Operative Time ◽

Right Colectomy ◽

R0 Resection ◽

Medial Approach ◽

Total Operative Time ◽

Advanced Tumors

Abstract Background The aim of this study was to compare the short-term outcomes of the duodenum-first multidirectional approach (DMA) in laparoscopic right colectomy with those of the conventional medial approach to assess its safety and feasibility. Methods This retrospective study enrolled 120 patients who had laparoscopic surgery for right-sided colon cancer in our institution between April 2013 and December 2019. Fifty-four patients underwent colectomy using the multidirectional approach; among these, 20 underwent the DMA and 34 underwent the caudal-first multidirectional approach (CMA). Sixty-six patients underwent the conventional medial approach. Complications within 30 days of surgery were compared between the groups. Results There were 54 patients in the multidirectional group [29 females, median age 72 years (range 36–91 years)] and 66 in the medial group [42 females, median age 72 years (range 41–91 years)]. Total operative time was significantly shorter in multidirectional approach patients than conventional medial approach patients (208 min vs. 271 min; p = 0.01) and significantly shorter in patients who underwent the DMA compared to the CMA (201 min vs. 269 min; p < 0.001). Operative time for the mobilization procedure was also significantly shorter in patients who underwent the DMA (131 min vs. 181 min; p < 0.001). Blood loss and incidence of postoperative complications did not differ. In 77 patients with advanced T3/T4 tumors, the DMA, CMA, and conventional medial approach were performed in 13, 21, and 43 patients, respectively. Total operative time and operative time of the mobilization procedure were significantly shorter in patients undergoing DMA. Blood loss and incidence of postoperative complications did not differ. R0 resection was achieved in all patients with advanced tumors. Conclusions The DMA in laparoscopic right colectomy is safe and feasible and can achieve R0 resection with a shorter operative time than the conventional medial approach, even in patients with advanced tumors.

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Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) with Preservation of Splenic Vessels: An Inferior-Posterior Approach

Gastroenterology Research and Practice ◽

10.1155/2018/1683719 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Yong Fei Hua ◽

Dipesh Kumar Yadav ◽

Xueli Bai ◽

Tingbo Liang

Keyword(s):

Blood Loss ◽

Distal Pancreatectomy ◽

Splenic Artery ◽

Posterior Approach ◽

Operative Time ◽

The Other ◽

Intraoperative Blood Loss ◽

Spleen Preserving ◽

Splenic Vessels ◽

Approach Group

Objective. To summarize the operation experience of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with preservation of splenic vessels by an inferior-posterior dissection of the pancreatic body and evaluate its feasibility. Methods. Patients undergoing LSPDS at Ningbo Li Huili Hospital and Ningbo Li Huili Eastern Hospital from January 2014 to April 2017 were recruited in this study and were analyzed retrospectively. They were divided into two groups based on the surgical approach: the inferior-posterior approach group and the other approach group. We sought to compare outcomes of the two groups. Results. The LSPDP procedure was completed successfully in 49 cases, and 48 patients had their splenic artery and vein preserved, including 26 cases in the inferior-posterior approach group and 22 cases in the other approach group. There were no significant differences between the two groups with respect to age (p=0.18), sex (p=0.56), preoperative diabetes (p=1.00), ASA grading (p=1.00), tumor size (p=0.91), intraoperative blood loss (t=−0.01, p=0.99), hospital stay (t=−0.02, p=0.98), and pancreatic fistula rates (p=1.00). Patients undergoing LSPDP by the inferior-posterior approach had a shorter operative time (t=−4.13, p<0.001) than the other approach group. Conclusions. LSPDS by the inferior-posterior approach associated with shorter operative time is safe and feasible.

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ALTERNATIVE TECHNIQUE FOR CHOLECYSTECTOMY COMPARABLE TO SINGLE PORT

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201700010015 ◽

2017 ◽

Vol 30 (1) ◽

pp. 53-55 ◽

Cited By ~ 3

Author(s):

Carlos SABBAG ◽

Ana BLITZCKOW

Keyword(s):

Laparoscopic Surgery ◽

Operative Time ◽

Single Port ◽

Alternative Technique ◽

New Techniques ◽

Cosmetic Results ◽

Aesthetic Results ◽

Conventional Material

ABSTRACT Background: With the advancement of laparoscopic surgery, new techniques have been proposed and disseminated in order to reduce the surgical aggression and get better cosmetic results. Aim: To present alternative technique for videocholecystectomy comparable to single port technique using conventional material for laparoscopic surgery. Method: Introduction of laparoscopic devices using two incisions; gallbladder traction with thread, exposition of Calot triangle, and ligature of cystic pedicle with polymer clips. Results: Nine operations were carried out with this method, without complications and no increase in operative time, being compared to conventional videocholecistectomy, however vastly superior in aesthetic results. Conclusion: The technique is feasible, reproducible, showing benefits to patient´s safety

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Initial experience of robotic single port plus one (SP + 1) distal pancreatectomy using the da Vinci SP system: A report of three cases with video

Annals of Hepato-Biliary-Pancreatic Surgery ◽

10.14701/ahbps.vp-12 ◽

2021 ◽

Vol 25 (1) ◽

pp. S137-S137

Author(s):

Young-Dong YU ◽

Hye-Sung JO ◽

Dong-Sik KIM

Keyword(s):

Distal Pancreatectomy ◽

Da Vinci ◽

Single Port ◽

Initial Experience ◽

System A

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Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) versus Open Spleen-Preserving Distal Pancreatectomy (OSPDP): A Comparative Study

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/9367868 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Jing Huang ◽

Dipesh Kumar Yadav ◽

Chaojie Xiong ◽

Ye Sheng ◽

Xinhua’ Zhou ◽

...

Keyword(s):

Postoperative Complications ◽

Blood Loss ◽

Hospital Stay ◽

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Operative Time ◽

Malignant Tumors ◽

Low Grade ◽

Intraoperative Blood Loss ◽

Spleen Preserving

Objective. To compare outcomes between laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and open spleen-preserving distal pancreatectomy (OSPDP) for treatment of benign and low-grade malignant tumors of the pancreas and evaluate feasibility and safety of LSPDP. Methods. The clinical data of 53 cases of LSPDP and 44 cases of OSPDP performed between January 2008 and August 2018 were retrospectively analyzed. The clinical outcomes between the two groups were compared. Results. There was no significant difference in preoperative data between the two groups. However, the LSPDP group had statistically significant shorter operative time (145.3±55.9 versus 184.7±33.5, P=0.03) and lesser intraoperative blood loss (150.6±180.8 versus 253.5±76.2, P=0.03) than that of the OSPDP group. Moreover, the LSPDP group also had statistically significant earlier passing of first flatus (2.2±1.4 versus 3.1±1.9, P=0.01), earlier diet intake (2.3±1.8 versus 3.4±2.0, P=0.01), and shorter hospital stay (6.2±7.2 versus 8.8±9.3, 0.04) than that of the OSPDP group. However, postoperative pancreatic fistula (P=0.64) and total postoperative complications (P=0.59) were not significantly different between the groups. The rate of pancreatic fistula and total postoperative complications occurred in 62.5% and 64.5%, respectively, in LSPDP group and, similarly, 70% and 70.0%, respectively, in OSPDP group. Conclusion. This study confirms that LSPDP is safe, feasible, and superior to OSPDP in terms of operative time, intraoperative blood loss, hospital stay, and postoperative recovery. Hence, it is worth popularizing LSPDP for benign and low-grade malignant tumors of the pancreas.

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FIRST SINGLE-PORT LAPAROSCOPIC PANCREATECTOMY IN BRAZIL

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032013000400013 ◽

2013 ◽

Vol 50 (4) ◽

pp. 310-312 ◽

Cited By ~ 5

Author(s):

Marcel Autran Cesar MACHADO ◽

Rodrigo Cañada Trofo SURJAN ◽

Fábio Ferrari MAKDISSI

Keyword(s):

Distal Pancreatectomy ◽

Single Incision ◽

Single Port ◽

Laparoscopic Approach ◽

Surgical Trauma ◽

Spleen Preserving ◽

Novel Technique ◽

The Past ◽

Advanced Access ◽

Access Surgery

ContextPancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. In the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. In the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures.ObjectivesWe present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and Latin America.MethodsA 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used.ResultsOperative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4.ConclusionsSingle-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons.

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