LAPAROSCOPIC PANCREATECTOMY - 11/09/11

Doi : 10.1016/S0039-6109(05)70460-6

Barry A. Salky, MD ^{^{*
From the Division of Laparoscopic Surgery, Mount Sinai Medical Center, New York, New York}}, Michael Edye, MB, BS ^{^{*
From the Division of Laparoscopic Surgery, Mount Sinai Medical Center, New York, New York}}

Resumen

Laparoscopy is still evolving in its approach to pancreatic disease. Although laparoscopic resection of malignant processes of the pancreas must be considered experimental and should be attempted only in the setting of approved protocols by institutional review boards, the use of laparoscopy in benign diseases is beginning to be explored. The approach to the retroperitoneal pancreas is not new. Two early reports by Meyer-Burg^{4 Meyer-Burg J. The inspection, palpation and biopsy of the pancreas by peritoneoscopy Endoscopy 1972 ; 4 : 99-101 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} (1972) and Ishida et al^{3 Ishida H., Furukawa Y., Kuroda H. , y al. Laparoscopic observation and biopsy of the pancreas Endoscopy 1981 ; 13 : 68-73 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} (1981) and later reports by Salky et al^{6 Salky B.A., Bauer J.J., Gelernt I.M., Kreel I. Laparoscopy for gastrointestinal diseases Mt Sinai J Med 1985 ; 52 : 228-232

Haga clic aquí para ir a la sección de Referencias, 7 Salky B.A., Bauer J.J., Gelernt I.M., Kreel I. The use of laparoscopy in retroperitoneal pathology Gastro Endosc 1988 ; 34 : 227-230 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} (1985, 1988) describe the use of laparoscopy in the approach to and diagnosis of pancreatic disease. The reader is encouraged to review these reports as background information to help understand the evolution of laparoscopic surgery in pancreatic disease. Inherent in the performance of laparoscopic surgery of the pancreas is the ability to access the retroperitoneum. In the era of therapeutic laparoscopy, Gagner et al^{1 Gagner M., Lacroix A., Bolte E., Pomp A. Laparoscopic adrenalectomy. The importance of a flank approach in the lateral decubitus position Surg Endosc 1994 ; 8 : 135-138 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} and Petelin^{5 Petelin JB: Laparoscopic adrenalectomy. Video abstract presented at the Third World Congress of Endoscopic Surgery, Bordeaux, France, June, 1992

Haga clic aquí para ir a la sección de Referencias} were early proponents of retroperitoneal access. Although their initial descriptions involved the adrenal gland, the approach was a precursor to laparoscopic pancreatic surgery.

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Esquema

LAPAROSCOPIC TRAINING

INSTRUMENTATION

PATIENT SELECTION

OPERATING ROOM SET-UP

OPERATIVE TECHNIQUE

Distal Pancreatectomy with Splenectomy^{Salky BA, Edye M, Gellman L: Laparoscopic distal pancreatectomy and splenectomy for mucinous cystadenoma of the pancreas. Video abstract presented at SAGES 1995 Scientific Session, Orlando, FL, March, 1995}

Distal Pancreatectomy with Splenic Salvage

Pancreaticoduodenectomy

RESULTS

Address reprint requests to Barry A. Salky, MD, Mount Sinai Medical Center, Division of Laparoscopic Surgery, Box 1103, 1 Gustave L. Levy Place, New York, NY 10029