Laparoscopic Pancreaticojejunostomy Anastamosis Using an Articulating Needle Holder.

INTRODUCTION

Pancreaticojejunal anastomosis is a technically challenging stage of the pancreaticoduodenectomy procedure for even the most experienced surgeon. We illustrate a buttressed duct-to-mucosa anastomosis (modified Blumgart technique) during laparoscopic pancreaticoduodenectomy using an articulating needle holder (FlexDex) (Video, Supplemental Digital Content 1, http://links.lww.com/SLE/A299).

MATERIALS AND

METHODS

While performing a minimally invasive pancreaticoduodenectomy, an articulating needle holder (FlexDex) is introduced through an 8 mm laparoscopic port and used to perform the duct-to-mucosa pancreaticojejunal anastomosis. Parenchymal buttressing using 3/0 double ended barbed suture (Stratafix) and pancreas duct to jejunum using 5/0 Prolene.Approval was obtained from the Office of Ethics and Research Governance at our institution. Consent was gained from the individual patient involved, to submit this intraoperative video for publication.

RESULTS

Successful intraoperative pancreaticojejunal anastomosis was performed using the articulating needle holder (FlexDex). The patient recovered from the procedure without complication, with no postoperative pancreatic fistula.

CONCLUSIONS

We demonstrate the feasibility of performing a laparoscopic pancreaticojejunal anastomosis using an articulating needle holder (FlexDex).