Soper et al. in 1994 were able to establish the safety and efficacy of laparoscopic distal pancreatectomy in an animal model, with no evidence of pancreatic leaks or fistulas. Later, in 1996, Cuschieri et al. described the technique they used to perform laparoscopic distal 70–80% pancreatectomy with en-bloc splenectomy in a group of five patients with intractable pain due to chronic pancreatitis. The authors demonstrated that this operation can be performed laparoscopically within an acceptable operating time and without major complications with advantages that include smaller incisions, less pain, and shorter postoperative recovery.
Identification of anatomical landmarks is crucial for this kind of procedure expecially when treating cancer. Augmented reality is a new tool to improve oncological safety, confirming the ideal dissection plane and anatomical landmarks, and to maximize functional preservation. The objective of this video is to demonstrate how to perform a splenopancreatectomy with removal of pancreatic cancer while keeping sufficient safety margins. Augmented reality is used in order to clearly identify the position of the anatomical landmarks: the splenic vein and artery, as well as the exact position of the tumor so that a sufficient resection margin can be identified.

complex cases