Laparoscopic radical antegrade modular pancreatosplenectomy

Although laparoscopic distal pancreatectomy is widely accepted for benign or borderline malignant pancreatic diseases, its application for pancreatic ductal adenocarcinoma (PDAC) remains controversial. Several recent reports have shown that laparoscopic surgery, for the treatment of PDAC, is associated with similar postoperative complications and survival outcomes compared with open surgery, and offers several advantages, particularly shorter hospital stay and less blood loss. However, potential risk of bias cannot be excluded because these results were obtained in retrospective studies. More importantly, it is unclear whether the extent of surgical resection is comparable between laparoscopic and open distal pancreatectomy. The aim of this video article is to show the technical feasibility of laparoscopic surgery to reproduce open radical antegrade modular pancreatosplenectomy (RAMPS) in terms of the extent of surgical resection.