Laparoscopic Distal Pancreatectomy with or without Preservation of the Spleen for Solid Pseudopapillary Neoplasm

Figure 2

(a) The pancreas was retracted during a dorsal approach (green arrow). (b) During the dorsal approach, the distal pancreas was securely mobilized by dissecting the connective tissue (red circle). (c) Removal of the pancreas by a dorsal approach was simulated preoperatively (red arrow). (d) Removal of the pancreas by a ventral approach was also simulated preoperatively (red arrow). (e) and (f) The pancreas was retracted (green arrow) and then a ventral approach was recommended to complete the removal of the pancreas (red arrow). (g) and (h) The pancreas was retracted using the forceps shaft and/or tape (green arrow). Next, connective tissue and the thin membrane surrounding the spleen were cut using a dorsal approach (red arrow). The distal pancreas and spleen were then completely removed.

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