Hand-assisted laparoscopic pancreatic resection.
The extent of reported laparoscopic pancreatic resections vary from enucleation to pancreaticoduodenectomy. Nevertheless, most patients with pancreatic disease who require resection are still treated with a traditional approach. Technological advancements in recent years may play an important role for the future diffusion of laparoscopic pancreatectomy. In hand-assisted laparoscopic surgery, the surgeon inserts a hand into the abdomen through a small laparotomy while pneumoperitoneum is maintained, and uses the hand to assist with dissection, palpation and retraction, control of blood vessels, manipulation of organs, and removal of the specimen. We present a review of our experience and of the world literature on hand-assisted laparoscopic pancreatic resection. Based on the first encouraging results, we believe that the hand-assisted technique should allow for substantial advantages to laparoscopic pancreatic surgery in the future.
Gagner
M
M
Division of Laparoscopic Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA.
Gentileschi
P
P
D004210:Dissection / Q000379:methods; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D004867:Equipment Design; D005544:Forecasting; D006225:Hand; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D020706:Laparoscopes / Q000592:standards / Q000600:supply & distribution; D010173:Palpation / Q000379:methods; D010180:Pancreatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D018579:Patient Selection; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome