Laparoscopic Pancreaticoduodenectomy with Transanal/Transvaginal Specimen Extraction

Abstract

Laparoscopic pancreaticoduodenectomy (LPD) is performed or assisted by laparoscopic technology. Laparoscopic pancreaticoduodenectomy is considered to be a very challenging operation due to the difficulty of anatomy, the removal of many organs, the complicated reconstruction of the digestive tract, and the high risk of postoperative complications. The operation is difficult, and the surgical team needs to have rich experience in open pancreaticoduodenectomy, skilled laparoscopic operation skills, and tacit surgical cooperation.

At the same time, natural orifice specimen extraction surgery (NOSES) continues to develop. It pursues smaller surgical incisions, avoids auxiliary incisions on the abdominal wall, and preserves the function of the abdominal wall to the greatest extent. It shows a good cosmetic effect, and the patient has light postoperative pain and quick recovery. Except that the way of specimen extraction is different from conventional laparoscopic surgery, specimen resection, lymph node dissection range, surgical separation levels, gastrointestinal reconstruction, etc., are the same as conventional laparoscopic surgery. Total laparoscopic pancreaticoduodenectomy without auxiliary incision in the abdomen to take specimens from the natural orifice belongs to the resection and drag-out NOSES. According to the method of specimen extraction, it is divided into transvaginal specimen extraction and transanal specimen extraction.