The Gastrohepatic Ligament Approach in Robotic Spleen-Preserving Distal Pancreatectomy with Resection of the Splenic Vessels: The Superior Window Approach in the Warshaw Technique

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Abstract

Background: There have been few studies reporting on the surgical approaches of minimally invasive spleen-preserving distal pancreatectomy (SPDP). Herein, we present two cases who underwent robotic SPDP with resection of the splenic vessels using our novel gastrohepatic ligament approach (the superior window approach in the Warshaw technique). Methods: Our gastrohepatic ligament approach in robotic SPDP consists of four steps: step 1, the gastrohepatic ligament transection; step 2, dissection around the pancreas; step 3, transection of the pancreas; and step 4, resection of the splenic vessels (the Warshaw technique). Results: Starting with the gastrohepatic ligament transection, the pancreas was directly dissected with neither dissecting the gastrocolic ligament nor retracting the stomach. The mean operative time was 217 min with minimal estimated blood loss. Both of the patients had no postoperative morbidity. Conclusions: The gastrohepatic ligament approach may be helpful and optional in robotic SPDP with the Warshaw technique.

Original languageEnglish
JournalJournal of Gastrointestinal Surgery
DOIs
Publication statusAccepted/In press - 2022
Externally publishedYes

Keywords

  • Gastrohepatic ligament
  • Robot
  • Spleen-preserving distal pancreatectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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