Laparoscopic Blumgart-style Pancreaticojejunostomy

Reconstruction Technique: Two-layer anastomosis without stent

 

00:18  TECHNIQUE OVERVIEW

04:05  TECHNIQUE FOOTAGE

Technique description
  • This reconstruction technique is inspired by the open Blumgart pancreaticojejunostomy, and has been modified to fit the constraints of the laparoscopic field.
  • The principle of this technique is to utilize trans-pancreatic sutures to create an invagination of the small bowel, which encapsulates the pancreas parenchyma, and the duct-to-mucosa anastomosis, on the anti-mesenteric side of the bowel.
  • Trans-pancreatic sutures are placed through the full thickness of the pancreas to prevent pancreas capsule tearing and relieve tension on the duct-to-mucosa anastomosis.
  • All knots on the outer layer of the anastomosis are tied on the anterior surface of the pancreas facilitating easier laparoscopic suturing.
Special acknowledgement

This video was a collaboration project with Dr. Shiva Jayaraman at St. Joseph's Health Centre.

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