1. Use of a short cartridge stapler is beneficial in pancreatic transection at the neck during laparoscopic distal pancreatectomy.
- Author
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Ishida J, Toyama H, Asari S, Goto T, Nanno Y, Mizumoto T, Tsugawa D, Komatsu S, Kuramitsu K, Yanagimoto H, Kido M, and Fukumoto T
- Subjects
- Humans, Surgical Stapling methods, Pancreas surgery, Pancreatic Fistula etiology, Pancreatic Fistula prevention & control, Postoperative Complications prevention & control, Pancreatectomy methods, Laparoscopy methods
- Abstract
Stapling is the standard method for pancreatic transection during laparoscopic distal pancreatectomy. Although most surgeons use a 60 mm cartridge stapler, space limitations created by laparoscopic surgery make the instrument difficult to handle, especially during pancreatic transection at the neck. Therefore, we currently use a 45 mm cartridge stapler for laparoscopic pancreatic transection at the neck. Between October 2019 and December 2020, we performed pancreatic transection using a 45 mm cartridge stapler in 27 patients. Fifteen patients experienced biochemical leakage, but no patients developed clinically relevant pancreatic fistula. The compactness of the 45 mm cartridge has several benefits: (1) less space is required for flexing, opening, and closing the device; (2) it enables easy insertion of the lower jaw behind the pancreas, even if the dissected space behind the pancreas is narrow; (3) less obstruction of the surgeons' view prevents accidental injury to the surrounding tissues and vessels. These benefits may enable safe pancreatic transection., (© 2022. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)
- Published
- 2023
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