New tools for laparoscopic division of the pancreas: a comparative animal study.
We tested the hypothesis that the pancreas can be safely divided laparoscopically using non-suture devices. Twelve pigs were randomized into 4 groups: 1) laparoscopic distal pancreatectomy (LDP) using an ultrasonic scalpel; 2) LDP using an ultrasonic scalpel with pancreatic stump suture reinforcement; 3) LDP using a 35-mm laparoscopic linear vascular stapler; 4) LDP using a prototype 35-mm radio-frequency laparoscopic linear vascular stapler. There were no serious complications related to distal pancreatectomy. All groups gained weight by postoperative day (POD) 14. Serum amylase, glucose, electrolytes and total bilirubin levels were measured preoperatively and on POD 1, 3, 7, and 14, and peripancreatic peritoneal fluid amylase levels were measured on POD 7 and 14; all remained normal in all groups. Fewer adhesions to the pancreatic stump were found in the ultrasonic scalpel groups as compared with the stapler groups. Ultrasonic dissection may be the superior means oflaparoscopic transection of the pancreas.
Center for Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, USA.
Eric J
EJ
Hanly
Mario
M
Mendoza-Sagaon
Jeffrey M
JM
Hardacre
Kazunori
K
Murata
Tracie E
TE
Bunton
Karen
K
Herreman-Suquet
Benjamin K
BK
Poulose
Mark A
MA
Talamini
D000818:Animals; D001707:Biopsy, Needle; D005260:Female; D007150:Immunohistochemistry; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D023421:Models, Animal; D010179:Pancreas / Q000473:pathology* / Q000601:surgery*; D010180:Pancreatectomy / Q000295:instrumentation / Q000379:methods*; D011336:Probability; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013528:Surgical Staplers; D034421:Sus scrofa; D013536:Suture Techniques; D014465:Ultrasonics