Ex vivo Whipple and small bowel autotransplantation
for pancreatic neuroendocrine tumour (PNETs)
00:15 SURGICAL PLANNING
02:48 MOBILIZATION & EXPOSURE OF SMA
03:58 PORTAL DISSECTION & RECONSTRUCTION OF RRHA
06:23 DIVISION OF THE PANCREAS & BOWEL
08:15 CONSTRUCTION OF SMV PANEL GRAFT
09:07 EX VIVO RESECTION OF THE PANCREATIC TUMOUR
11:49 CONSTRUCTION OF THE IMV-IVC SHUNT
CASE DESCRIPTION
- The patient was a 44-year-old woman with pancreatic neuroendocrine tumour (PNET) in the head of the pancreas.
- The tumour had invaded the SMV and extensive venous collaterals have developed, but the SMA did not appear to be invaded.
- The surgical plan was to perform an ex vivo bowel and pancreas resection.
- The specimen and small bowel were removed and brought to the backbench for resection. The SMA was dissected away from the tumour and SMV was divided below the tumour margin.
- While the backbench dissection was performed, the IMV was reconstructed to the IVC to allow the colon to have venous drainage during ex vivo.
- After the specimen was removed, a superficial femoral vein (SFV) was reconstructed to the SMV, and the small bowl complex was transferred back into the abdominal cavity.
- Vascular, pancreatic, biliary, and gastric reconstructions were then performed.
CT SCAN
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