title: Lesser curvature approach in laparoscopic distal pancreatectomy.
abstract: Laparoscopic distal pancreatectomy (LDP) has entailed ventrally retracting the stomach to afford adequate visualization. The retracted stomach commonly droops over the pancreas and obstructs the surgical field, thus forcing the assistant surgeon to repeatedly lift the stomach out of the way ventrally and cranially. We herein reported LDP using the "lesser curvature approach" in which the pancreas was approached cephalad to the lesser curvature of the stomach in underweight patients with a coincidental low hanging stomach. An excellent view of both the distal pancreas and the spleen could be afforded, enabling complete mobilization of these organs from the retroperitoneum and easy ligation of the splenic vessels, without needing to retract the stomach ventrally and cranially. The lesser curvature approach in LDP could be performed safely and efficiently as an alternative to the conventional greater curvature approach in underweight patients with a low hanging stomach.
authors.affiliation: Department of Surgery, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan. suzuki.on@ims.gr.jp
authors.forename: On
authors.initials: O
authors.lastname: Suzuki
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Nakamura
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Ambo
authors.forename: Toru
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kishida
authors.forename: Nobuichi
authors.initials: N
authors.lastname: Kashimura
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D010149:Postoperative Pain / Q000503:physiopathology; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D010529:Peritoneal Cavity / Q000601:surgery; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome