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Bijan GHAVAMI

Clinique de la Source
Lausanne, Switzerland
MD
519 likes
42.4K views
5 comments
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Total laparoscopic pancreaticoduodenectomy with pancreaticogastric anastomosis
The safe feasibility of total laparoscopic pancreaticoduodenectomy has been demonstrated by several authors. In order to achieve it, a 5-port approach is used. Kocher’s maneuver allows to access the inferior vena cava, the subrenal aorta, the posterior plate of the unciform process, and the superior mesenteric artery. Lymph node resection of the region may be performed completely, namely an interaorticocaval lymphadenectomy around the hepatoduodenal ligament and around the coeliac trunk and its branches. After portal vein dissection, the pancreas must be divided distally from the tumor, and its right part must be separated from the portal vein. The duodenal bulb and the first jejunal loop are divided using a linear stapler. After cholecystectomy, the hepatic duct is cut proximally to the cystic duct. Reconstruction will include three anastomoses, a telescoping posterior end-to-side pancreaticogastrostomy, an end-to-side duodenojejunostomy, and an end-to-side hepaticojejunostomy.
B Ghavami
Surgical intervention
2 years ago
1757 views
60 likes
0 comments
13:35
Total laparoscopic pancreaticoduodenectomy with pancreaticogastric anastomosis
The safe feasibility of total laparoscopic pancreaticoduodenectomy has been demonstrated by several authors. In order to achieve it, a 5-port approach is used. Kocher’s maneuver allows to access the inferior vena cava, the subrenal aorta, the posterior plate of the unciform process, and the superior mesenteric artery. Lymph node resection of the region may be performed completely, namely an interaorticocaval lymphadenectomy around the hepatoduodenal ligament and around the coeliac trunk and its branches. After portal vein dissection, the pancreas must be divided distally from the tumor, and its right part must be separated from the portal vein. The duodenal bulb and the first jejunal loop are divided using a linear stapler. After cholecystectomy, the hepatic duct is cut proximally to the cystic duct. Reconstruction will include three anastomoses, a telescoping posterior end-to-side pancreaticogastrostomy, an end-to-side duodenojejunostomy, and an end-to-side hepaticojejunostomy.
Duodenopancreatectomy: potentialities of the laparoscopic approach in the mobilization, dissection, and resection stages of the procedure
This video demonstrates the laparoscopic approach of a cephalic
duodenopancreatectomy in a 70-year-old patient presenting with an
adenocarcinoma of the pancreatic head. Using 4 ports, the duodenum is completely detached. The unciform process is prepared posteriorly by dissecting the superior mesenteric artery and the portal vein in its right lower section. A total lymph node resection and an antrectomy have been performed, followed by the resection of the pancreatic body. Last but not least, the small bowel is divided and the duodenum is de-crossed. The dissection shows the different steps of the procedure with extra details.
B Ghavami
Surgical intervention
9 years ago
13334 views
192 likes
5 comments
17:55
Duodenopancreatectomy: potentialities of the laparoscopic approach in the mobilization, dissection, and resection stages of the procedure
This video demonstrates the laparoscopic approach of a cephalic
duodenopancreatectomy in a 70-year-old patient presenting with an
adenocarcinoma of the pancreatic head. Using 4 ports, the duodenum is completely detached. The unciform process is prepared posteriorly by dissecting the superior mesenteric artery and the portal vein in its right lower section. A total lymph node resection and an antrectomy have been performed, followed by the resection of the pancreatic body. Last but not least, the small bowel is divided and the duodenum is de-crossed. The dissection shows the different steps of the procedure with extra details.