How to Perform a Rotational Gerota's Fascia Flap: A Novel Technique for High-Risk Pancreatic Stump Coverage After Distal Pancreatectomy.

Clinically relevant postoperative pancreatic fistula (CR-POPF) remains a significant morbidity after distal pancreatectomy (DP). The article describes a novel technique using a rotational Gerota's fascia flap to reinforce the pancreatic stump in patients at high risk for CR-POPF. This method offers a readily accessible, autologous, vascularized tissue option that may be valuable when omentum or falciform ligament tissue is inadequate. To our knowledge, this represents the first described use of Gerota's fascia for pancreatic stump reinforcement.