title: Laparoscopic three-port distal pancreatectomy.
abstract: OBJECTIVE
  Laparoscopic distal pancreatectomy is becoming a more commonly used procedure, which may involve the use of four to seven ports, depending on the technique. Initial data on feasibility, safety and outcome with the three-port laparoscopic distal pancreatectomy are presented.
  
  
  METHODS
  The patient is placed in a partial thoracoabdominal position exposing the left flank in a reverse Trendelenberg position. A 10-mm Hassan trocar is inserted through a subcostal anterior axillary incision. A 5-mm midclavicular and 10-mm posterior axillary line trocar are placed. The specimen is retrieved from the anterior axillary line port.
  
  
  RESULTS
  Ten women and seven men, aged 26-88 years (mean 61 years), were evaluated. Their body mass indexes ranged from 18-37 (mean 27). Pancreatic lesion size ranged from 1.0-5.5 cm (mean 3.0 cm). Operative time was 116-296 min (mean 170 min). Blood loss was 10-300 ml (mean 142 ml). No operation required conversion or additional trocar placement. Post-operative stay was 2-7 days (mean 4 days). No patient developed a pancreatic fistula.
  
  
  CONCLUSIONS
  Operative time, blood loss and post-operative stay of this three-port technique compare favourably with published data.
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, USA.
authors.forename: Gokulakkrishna
authors.initials: G
authors.lastname: Subhas
authors.forename: Natasha
authors.initials: N
authors.lastname: Gupta
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Mittal
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D018475:Head-Down Tilt; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008923:Missouri; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D056888:Patient Positioning; D012189:Retrospective Studies; D013156:Splenectomy; D013997:Time Factors; D016896:Treatment Outcome