LEFT-POSTERIOR ARTERY-FIRST APPROACH WITH SCOPE TRANSITION FOR THE DISSECTION OF THE SUPERIOR MESENTERIC ARTERY DURING ROBOT-ASSISTED PANCREATICODUODENECTOMY

An optimal approach to the SMA for dissection around the superior mesenteric artery (SMA) in robot-assisted PD has not been established. In this video, we detaile surgical technique of the left-posterior (LP) approach to the SMA.
The LP approach was performed at the first stage of resection. The robo-scope was inserted from the left-sided trocar. The left and posterior sides of the SMA were dissected along with proximal mesojejunum resection. The common trunk of the jejunal artery and inferior pancreaticoduodenal artery were divided during this approach. The remnant part of the SMA was dissected from the right at the final stage of resection by the right-sided scope using scope transition.