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<sup>4 Meyer-Burg J. The inspection, palpation and biopsy of the pancreas by peritoneoscopy Endoscopy 1972 ;  4 : 99-101  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> (1972) and Ishida et al<sup>3 Ishida H., Furukawa Y., Kuroda H. , e al. Laparoscopic observation and biopsy of the pancreas Endoscopy 1981 ;  13 : 68-73  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> (1981) and later reports by Salky et al<sup>6 Salky B.A., Bauer J.J., Gelernt I.M., Kreel I. Laparoscopy for gastrointestinal diseases Mt Sinai J Med 1985 ;  52 : 228-232

Cliccare qui per andare alla sezione Riferimenti, 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]

Cliccare qui per andare alla sezione Riferimenti</sup> (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<sup>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]

Cliccare qui per andare alla sezione Riferimenti</sup> and Petelin<sup>5 Petelin JB: Laparoscopic adrenalectomy. Video abstract presented at the Third World Congress of Endoscopic Surgery, Bordeaux, France, June, 1992

Cliccare qui per andare alla sezione Riferimenti</sup> were early proponents of retroperitoneal access. Although their initial descriptions involved the adrenal gland, the approach was a precursor to laparoscopic pancreatic surgery.