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Case Reports in Surgery
Volume 2018, Article ID 1978362, 6 pages
Case Report

A Modified Technique for Laparoscopic Spleen Preserving Distal Pancreatectomy

13rd Department of Surgery, Evangelismos General Hospital, Athens, Greece
2Department of Anatomy, Medical School, University of Athens, Athens, Greece

Correspondence should be addressed to Andreas Papatriantafyllou; moc.liamtoh@tapapdna

Received 10 August 2017; Revised 30 December 2017; Accepted 8 January 2018; Published 19 February 2018

Academic Editor: Gabriel Sandblom

Copyright © 2018 Andreas Papatriantafyllou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Spleen preserving laparoscopic distal pancreatectomy is considered as first choice operation for symptomatic benign or small malignant lesions located at the body or tail of the pancreas. The two main surgical techniques that have been proposed and widely adopted for spleen preserving laparoscopic distal pancreatectomy are the Warshaw and Kimura techniques. A novel modified approach for laparoscopic spleen preserving distal pancreatectomy is presented. The technique was initially performed in a 57-year-old female patient with mucinous cystadenoma. Following the surgical planes created by the fascia fusion and the organ rotation during embryogenesis (fascia of Toldt and renal fascia) with the patient in a right lateral decibutus position, the tumor was accessed retroperitoneally, without dividing the gastrocolic ligament and entering the lesser sac. The tail of the pancreas was mobilized anteriorly and medially, the lesion was visually identified and resected, and short gastric and left gastroepiploic vessels were preserved. We present the technical details and tips; we define the surgical anatomy of it and discuss the perioperative course of the patient as well as the possible benefits of the proposed technique. The proposed technique seems to be safe, easy to perform, and may present a promising alternative approach for patients with pancreatic disease that can be treated by laparoscopic pancreatectomy.