Research Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2014; 20(22): 6878-6883
Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.6878
Laparoendoscopic single-site distal pancreatectomy in pigs
Dong Wang, Zhen-Ling Ji, Xiao-Hua Jiang, Jing-Min Wang, Yu-Yan Tan, Yan Wang, Ya-Zhou Wen
Dong Wang, Zhen-Ling Ji, Xiao-Hua Jiang, Jing-Min Wang, Yu-Yan Tan, Department of General Surgery, Zhongda Hospital, Institute for Minimally Invasive Surgery, Southeast University Medical School, Nanjing 210009, Jiangsu Province, China
Yan Wang, Department of Obstetrics and Gynecology, Zhongda Hospital, Southeast University Medical School, Nanjing 210009, Jiangsu Province, China
Ya-Zhou Wen, Department of Anesthesiology, Zhongda Hospital, Southeast University Medical School, Nanjing 210009, Jiangsu Province, China
Author contributions: Wang D performed the majority of experiments and wrote the manuscript; Ji ZL and Jiang XH designed the study and performed the critical part of the experiments; Wang JM provided the surgical instruments and was the operative assistant; Tan YY performed as the anesthesia assistant and collected the data of the study; Wang Y provided the surgical instruments and was also involved in editing the manuscript; Wen YZ provided narcotic drugs and performed the anesthesia management.
Correspondence to: Zhen-Ling Ji, Professor, Department of General Surgery, Zhongda Hospital, Institute for Minimally Invasive Surgery, Southeast University Medical School, 87 Ding jia qiao, Nanjing 210009, Jiangsu Province, China. zlji@seu.edu.cn
Telephone: +86-25-83262301 Fax: +86-25-83262301
Received: November 6, 2013
Revised: February 17, 2014
Accepted: March 19, 2014
Published online: June 14, 2014
Abstract

AIM: To explore the technique for laparoendoscopic single-site distal pancreatectomy.

METHODS: Laparoendoscopic single-site spleen-preserving distal pancreatectomy was performed in pigs using a novel flexible multichannel port, a curved laparoscopic multifunctional operative device and a fish hook retractor, which provided a favorable operative field.

RESULTS: Six pigs were involved in this study, and five survived the procedure. The first animal died following injury to the superior mesenteric vein and uncontrolled intraoperative bleeding. Except for this failure, the mean operative time was 155 min (range: 102-236 min). A steep learning curve was observed in the study, with a mean operative time of 177 min in the first two operations vs 134 min in the last three operations. The mean blood loss was 50 mL, and the postoperative course was uneventful. The animals were sacrificed three weeks after the procedures, and no pancreatic leakage or abdominal infection was found macroscopically.

CONCLUSION: Laparoendoscopic single-site distal pancreatectomy is a safe and feasible procedure and can be implemented in humans in selected cases at qualified surgical centers.

Keywords: Laparoendoscopic single-site surgery, LESS, Pancreatectomy, Fish hook retraction, Curved laparoscopic multifunctional operative device

Core tip: Laparoendoscopic single-site surgery (LESS) is a rapidly evolving field in minimally invasive surgery. LESS requires specialized instruments and is a technically demanding procedure that is particularly challenging for pancreatic surgery. We present our surgical technique for laparoendoscopic single-site distal pancreatectomy in pigs using a novel flexible multichannel port, a curved laparoscopic multifunctional operative device and a fish hook retractor, which provided a favorable operative field. It is a safe and feasible procedure and can be implemented in humans in selected cases. To our knowledge, this is the first surgical series of laparoendoscopic single-site distal pancreatectomy in pigs reported in the literature.