PMC9912550_01
Postcontrast CT images of the pancreatic masses: (a) left cranial pancreatic
limb mass (arrows) in transverse plane; (b) the same left cranial pancreatic
limb mass (arrows) in dorsal plane, in relation to the transverse colon; and
(c) left caudal pancreatic limb mass (arrows) in transverse plane
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CT showed a small (2.5 cm x 3.2 cm x 2.0 cm [length x width x height]), moderately heterogeneous mass in the cranial aspect of the left pancreatic limb, as well as a small (0.8 x 0.8 x 1.0 cm [length x width x height]), poorly marginated, heterogeneous nodule in the caudal extent of the left pancreatic limb (Figure 1).
Illustration of the three-port laparoscopic technique. The first 5 mm port
was placed just caudal to the umbilicus, the second 5 mm port was placed
4 cm to the right of midline just caudal to the last rib and the third 5 mm
port was placed 4 cm cranial to the umbilicus on midline
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The second 5 mm port was placed 4 cm to the right of midline just caudal to the last rib, and the third 5 mm port was placed 4 cm cranial to the umbilicus on midline under visualization (Figure 2).
Laparoscopic image. The pancreas appeared normal in color, but a dark pink
nodule (star) was seen within the left limb approximately 1 cm from the body
of the pancreas
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Tip Laparoscopic Sealer/Divider; Covidien) was used to enter the omental bursa to visualize the left limb of the pancreas. The pancreas appeared normal in color, but two obvious nodules were seen within the left limb: one in the mid-limb and one approximately 1 cm from the body of the pancreas (Figure 3).
Laparoscopic image. A laparoscopic blunt probe is seen retracting the stomach
cranially and ventrally, and the vessel sealing device seen at the bottom of
the screen was used to dissect the pancreatic tissue from the mesentery
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Grasping the mesentery with an atraumatic laparoscopic forceps and starting at the distal tip of the left limb of the pancreas, the VSD was used to deliberately dissect the pancreatic tissue from the mesentery (Figure 4).