Pure laparoscopic pancreas parenchymal dissection using CUSA for distal pancreatectomy

Keiichi OkanoDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan; Correspondence[email protected]

Hironobu SutoDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

Minoru OshimaDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

Yasuhisa AndoDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

Eisuke AsanoDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

Takayoshi KishinoDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

Masao FujiwaraDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

Hideki KobaraGastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan

http://orcid.org/0000-0002-8508-827X

Hirohito MoriGastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan

http://orcid.org/0000-0002-1691-2085

Tsutomu MasakiGastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan

http://orcid.org/0000-0002-8425-0685

Yasuyuki SuzukiDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan;

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Abstract

Although stapler dissection and closure is commonly used for laparoscopic distal pancreatectomy (LDP), it is risky in patients with thick pancreatic parenchyma or titanium allergy. We performed laparoscopic pancreatic parenchymal dissection with cavitron ultrasonic surgical aspirator (CUSA) successfully in a patient with titanium allergy. Slinging the pancreas with nylon tape delineates the surgical plane. Pancreatic parenchyma was transected by CUSA in an almost bloodless field. Pancreatic duct branches and vessels were adequately exposed and dissected with a vessel sealing system. The main pancreatic duct was closed with Hem-O-lock. CUSA is an alternative to stapler dissection during LDP in select patients.

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Pure laparoscopic pancreas parenchymal dissection using CUSA for distal pancreatectomy

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Pure laparoscopic pancreas parenchymal dissection using CUSA for distal pancreatectomy

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