Use of an endoscopic surgical spacer during laparoscopic pancreatic tumor enucleation

J Nippon Med Sch. 2010 Apr;77(2):106-10. doi: 10.1272/jnms.77.106.

Abstract

A number of recent reports have highlighted the usefulness of laparoscopic surgery for pancreatic surgery; however, the procedure is not yet standard because of its technical challenges. Using an endoscopic surgical spacer (SECUREA) that we developed, we performed laparoscopic enucleation of a pancreatic tumor in a patient with pancreatic mucinous cystadenoma. The SECUREA is a polyurethane sponge with a radiopaque marker. It is elliptic-cylindrical and measures 6.5 cm on the major axis, 3.5 cm on the minor axis, and 2 cm in height. Herein, we report the intraoperative findings and examine the usefulness of SECUREA for laparoscopic enucleation. The spacer was introduced into the abdominal cavity through a 12-mm trocar, and was grasped with forceps to isolate or extend organs and tissues, thereby ensuring a safe and relatively uncontaminated surgical field. In addition, the high absorptiveness and water-holding capacity of the sponge facilitated removal of exudate, which created a clearer operative field and reduced the technical challenges of drainage manipulation. Indeed, replacement of the sponge was unnecessary because it returned to its original state after the liquid it contained had been aspirated. Our findings suggest that the SECUREA increases safety and reduces the technical difficulties of laparoscopic enucleation.

Publication types

  • Case Reports

MeSH terms

  • Cystadenoma, Mucinous / diagnostic imaging
  • Cystadenoma, Mucinous / surgery*
  • Equipment Design
  • Female
  • Humans
  • Laparoscopy*
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / surgery*
  • Polyurethanes
  • Suction
  • Surgical Sponges*
  • Therapeutic Irrigation
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Polyurethanes