Robotic Whipple Procedure for an Ampullary Intramucosal Carcinoma
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Procedure Outline
Table of Contents
- 1. Introduction
- 2. Laparoscopic Access, Diagnostic Laparoscopy, and Biopsy of a Liver Nodule
- 3. Division of Falciform Ligament and Liver Retraction with Transfascial Endoloop Suture
- 4. Mini-Pfannenstiel Incision
- 5. Robot Docking
- 6. Division of Gastrocolic Ligament, Mobilization of Right Colon, and Kocher Maneuver
- 7. Pancreaticoduodenectomy and Lymphadenectomy
- 8. Pancreaticojejunostomy
- 9. Hepaticojejunostomy
- 10. Gastrojejunostomy
- 11. Robot Undocking
- 12. Laparoscopic Access, TAP Block, Additional Irrigation and Suction, and Application of Fibrin Sealant
- 13. Desufflation and Closure
- 14. Post-op Remarks
- Skin Marking
- Port Placement, Insufflation with Hasson's Technique, and Diagnostic Laparoscopy
- Biopsy of the Liver Nodule
- Frozen Section Results
- Preparation for GJ Anastomosis
- Kocher Maneuver
- Inframesocolic Dissection of Duodenojejunal Flexure
- Division of Proximal Jejunum
- Further Retrograde Dissection of Duodenum
- Division of Stomach Proximal to Pylorus
- Excision Biopsy of Station 8 Lymph Node
- Ligation and Division of Gastroduodenal Artery
- Cholecystectomy
- Dissection of Extrahepatic Bile Ducts Within Hepatoduodenal Ligament; Ligation and Division of Common Hepatic Duct
- Creation of Retropancreatic Tunnel and Division of Pancreas at its Neck
- Conclusion of Pancreaticoduodenal Resection: Mobilization and Excision of Duodenum and Head of Pancreas
- Retrieval of Specimen
