PMC5067293_01
A. Gastric endoscopy revealed the cancer in antrum. The arrow shows the gastric cancer. B. Hematoxylin and eosin (H.E.) stained dissected tissues of stomach.
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The pathohistology of the dissected tissue demonstrated that the histology was moderately differentiated adenocarcinoma, and the depth of the gastric cancer was pT1b2 (submucosal layer: ~1000 mum, tumor size: 10 mm x 10 mm) with vertical and horizontal negative margins (Fig. 1).
Computed tomography (CT) scan that was performed preoperative, revealed a tumor in the pancreatic tail.
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Computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed a tumor, 1.5 cm in diameter, in the pancreatic tail; however, no metastatic lymph node was revealed (Fig. 2).
A scheme of the pancreas dissected from the postperitoneal cavity using hand-assisted laparoscopy.
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A pancreatectomy was performed extracorporeally under direct vision after detaching the spleen and the distal pancreas from the retroperitoneum under hand-assisted laparoscopy (Fig. 3).
A scheme of the ports that were inserted in the surgery.
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Another two ports were inserted, resulting in five ports, including the GelPort  (Fig. 4).
Computed tomography (CT) scan that was performed six months after surgery, revealed the patency of the splenic artery and vein.
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Six months after surgery, an enhanced CT scan revealed the patency of the splenic artery and vein and no infarction of the spleen (Fig. 5).