Laparoscopic pancreatic surgery can be performed in skilled or experienced surgeons as an alternative to the traditional open surgery. The main difference between laparoscopic pancreatic surgery and traditional open surgery is that the former doesn’t require making a large incision, as it can be completely performed through minor incisions.
Pancreas cancer is likely to disseminate to other tissues and organs as it progresses to later stages. The Pancreas Cancer Surgeon will need to accurately identify the extent of cancer dissemination. This may require utilizing the diagnostic laparoscopy technique. Based on pancreas examination and diagnostic test results, your surgeon will decide the type of surgery best for your pancreas cancer stage and condition.
Commonly performed laparoscopic pancreatic surgeries include the following:
1. Laparoscopic distal pancreatectomy
Pancreatectomy refers to the removal of the pancreas. Depending on how much of the pancreas is affected, your surgeon will determine how much needs to be removed. Laparoscopic distal pancreatectomy is the surgery of choice in cases of pancreatic cysts, neuroendocrine tumors, and cancer which is localized in the body or tail of the pancreas.
2. Laparoscopic enucleation of pancreatic nodule (islet cell tumours)
Some pancreatic nodules may be suitable for enucleation if they are benign, and located away from the pancreatic duct. This procedure preserves most of the pancreatic tissue. Typically, this can be done for insulinoma (pancreatic islet cell tumours).
3. Pancreatic pseudocysts (drainage procedure)
Severe acute pancreatitis can cause pancreatic fluid leaks. This can result in formation of fluid-filled growths that may obstruct the stomach and cause vomiting. For such cases, a laparoscopic pancreatic surgery (pancreatic cystogastrostomy) may help drain the pancreatic fluid.
4. Necrotising pancreatitis
Patients with necrotising pancreatitis may require debridement or removal of dead pancreatic tissue. This can be done laparoscopically and is preferred as it is less invasive. Repeated procedures may be necessary till sufficient non-viable pancreatic tissue is removed.
Two potential post-operative complications of pancreatic surgery are pancreatic leak and diabetes. Pancreatic leaks are not always avoidable, but are best managed by an experienced pancreatic surgeon. Uncontrolled pancreatic leaks may be life-threatening, and result in fever, abdominal abscess and wound problems. Some patients may develop diabetes after pancreatic surgery. This will depend on the extent of surgery, and may occur after Whipples surgery (where most of the insulin-producing cells are located).
Do consult your surgeon regarding laparoscopic or minimally invasive options for pancreatic surgery.
Senior Consultant Surgeon
MBBS (Singapore), FRCS (Edinburgh), MMed (Surgery), MSc (Bioinformatics),
FAMS (General Surgery)
With 20 years of surgical experience, Dr Lee is trained and skilled in using minimally invasive techniques for liver, pancreas, gallbladder and hernia procedures.
His busy practice aside, Dr Lee is actively involved in postgraduate teaching and workshops for junior surgeons, and is still actively involved in academic research at the National University of Singapore.
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