الفهرس | Only 14 pages are availabe for public view |
Abstract The field of laparoscopic pancreatic surgery is still in its developmental phase despite an increasing number of case reports and small single- institution case series of laparoscopic pancreatic procedures. Only a few years ago the application of laparoscopic surgery in PC was limited to diagnosis and palliation. Now, improved technique allows for technically safe and oncologically sound laparoscopic resection of PC in both the proximal and the distal pancreas. No prospective studies have been done that show an advantage of laparoscopic surgery in the treatment of pancreatic disease. Thus, the descriptions that follow reflect what has been reported as technically feasible, although the advantages of a laparoscopic approach over open surgery for pancreatic disease remain under evaluation. Minimally invasive surgery has grown exponentially since its early days and there are now very few procedures to which these techniques have not been applied. Laparoscopic pancreatic surgery was until recently beyond the reach of most surgeons for a variety of reasons, including inexperience, lack of adequate training programs, and complexity of the anatomy and diseases. Advances in tumor localization and imaging, as well as instrumentation and robotics will hopefully aid in the utilization of LPS techniques by a larger number of surgeons who treat pancreatic neoplasms. Certainly it must have been difficult, if not impossible, for surgeons of prior generations to foresee the current widespread use of minimally invasive techniques to complicated pancreatic surgery. It is with that in mind that one must look to the future with cautious optimism and realize that many of the procedures we perform today will long be replaced by less invasive treatments. |