title: Securing the surgical field in laparoscopic pancreatectomy using a Penrose drain and Endo Close.
abstract: BACKGROUND
  We adopted the use of Penrose drains and Endo Close to secure a good surgical field during laparoscopic pancreatectomy.
  
  
  METHODS
  We used a Penrose drain with threads ligated on both ends to suspend the stomach. We then pulled the threads out of the body from the side of the trocar or from besides the xiphisternum by using Endo Close. In most cases, 2 Penrose drains were used to retract the stomach. When the greater omentum on the left side of the cardia still blocks the surgical field, we sewed the posterior wall of the stomach onto the dome of the diaphragm.
  
  
  RESULTS
  The use of 2 Penrose drains and Endo Close were effective to retract the stomach in most cases. However, in 3 cases, we needed to additionally sew the stomach onto the diaphragm to fully open up the field.
  
  
  CONCLUSIONS
  This is a simple and effective method to ensure a good surgical field.
authors.affiliation: Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sunose
authors.forename: Keitaro
authors.initials: K
authors.lastname: Hirai
authors.forename: Seshiru
authors.initials: S
authors.lastname: Nakazawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshinari
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsukagoshi
authors.forename: Norifumi
authors.initials: N
authors.lastname: Takahashi
authors.forename: Hodaka
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Yoko
authors.initials: Y
authors.lastname: Motegi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Miyamae
authors.forename: Takamichi
authors.initials: T
authors.lastname: Igarashi
authors.forename: Kengo
authors.initials: K
authors.lastname: Takahashi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Katoh
authors.forename: Kazumi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Izumi
authors.initials: I
authors.lastname: Takeyoshi
mesh_terms: D004322:Drainage / Q000295:instrumentation; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D010180:Pancreatectomy / Q000295:instrumentation* / Q000379:methods