Transecting the pancreas neck with electrothermal bipolar vessel sealer (LigaSure) in laparoscopic left pancreatectomy: case report.
BACKGROUND
Pancreatic fistula after distal pancreatectomy remains an unsolved problem, ranging in frequency between 15% and 40%, regardless of whether the intervention is performed laparoscopically or by open surgery.


METHODS
Herein, presenting the case of a 68-year-old woman with a functioning insulinoma submitted to laparoscopic spleen preserving distal pancreatectomy, we propose a new technique of pancreatic transection by the LigaSure system, which seals vessels and other tubular structures by reforming parietal collagen and elastin.


RESULTS
The patient had a favorable outcome. The reported technique presents the advantages of an easy employ and of a contemporary hemostasis, thus being particularly suitable by the laparoscopic way, and may offer from a theoretical point of view some advantages over conventional pancreatic stump closure techniques in terms of fistula formation.


CONCLUSIONS
Laparoscopic pancreatic transection by LigaSure may prove useful, safe, and effective. A prospective clinical study has now been designed to confirm such hypothesis.


OBJECTIVE
A simple and safe technique for pancreas neck transection, particularly suitable for laparoscopic left pancreatectomy, is described.
Division of General Surgery, Castelfranco Veneto Hospital, Italy.
Carlo Augusto
CA
Sartori
Gian Luca
GL
Baiocchi
D000368:Aged; D004564:Electrocoagulation; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007340:Insulinoma / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008026:Ligation / Q000379:methods; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000601:surgery*; D013154:Spleen