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Laparoscopic gastropancreatoduodenal resection

Laparoscopic gastropancreatoduodenal resection
Professor Khat’kov I.E. is performing an operation.

A 58 year-old patient has a diagnosis “Cancer of the pancreas head pT2N0M0” After transection of the gastrocolic ligament by an ultrasonic scalpel adhesioviscerolysis in omentum sac is done. Then mobilization of the inferior edge of pancreas is done with the visualization of the superior mesenteric vein (SMV). After mobilization of duodenum according to Kocher its transection is done in the proximal part. After that mobilization of the elements of the hepatoduodenal ligament (HDL) is done. The gastroduodenal artery is transected after clipping. Then transection of small colon is done, mobilization of the uncinate process, lymphadenectomy along the superior mesenteric artery is performed. Choledoch is transected by scissors, the edges of the bile duct and pancreas are sent for urgent histological investigation. Dissection is performed along the superior mesenteric artery, and then the final mobilization of the uncinate process is done. 2 anastomoses have been formed in a consecutive order: invaginational pancreatoenteroanastomosis, using interrupted sutures and TiCron 2-0 thread and hepaticojejunoanastomosis, performed by the gastroenteroanastomosis apparatus.

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