From
StayCurrentMD
Laparoscopic Distal Pancreatectomy for Traumatic Transection
Part of
Blunt Abdominal Trauma 8 items
Chapter 1 of 4 · Case-Based Learning
Case presentation
Case presentation and surgical approach rationale
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
Intestinal Atresia Types Explained: Grossfeld Classification for Pediatric Surgery
1 min · Published Sep 2026
Video
Derivation and validation of the Pediatric Community-Acquired Pneumonia Severity (PedCAPS) score: A prospective cohort study
50 s · Published Sep 2026
Video
FETO for Late-Diagnosed Severe Congenital Diaphragmatic Hernia (CDH) at Cincinnati Children's with Dr. Beth Rymeski
4 min · Published Sep 2026
Video
Severe Congenital Diaphragmatic Hernia (CDH) Case: FETO Management & Unexpected Findings with Dr. Beth Rymeski
3 min · Published Sep 2026
Video
Fetoscopic Endoluminal Tracheal Occlusion (FETO) Procedure: Step-by-Step Guide with Dr. Beth Rymeski
4 min · Published Sep 2026
Video
Choledochal Cyst Types Explained: Pediatric Surgery Fundamentals
1 min · Published Sep 2026
What the experts said
Resection versus non-operative management for traumatic pancreatic transection is still somewhat controversial.
The pediatric surgery service strongly prefers an early distal pancreatectomy in cases of pancreatic transection.
Distal pancreatectomy for traumatic transection was typically done through a laparotomy.
This video demonstrates the first laparoscopic distal pancreatectomy for trauma at this institution.
A 3-trocar approach was used: a 12 millimeter trocar at the umbilicus for camera, stapler, and specimen extraction, and two 5 millimeter upper abdominal trocars for grasping and dissection.
The lesser sac is widely opened using the LigaSure to reveal the posterior wall of the stomach.
A large curved needle is brought through the abdominal wall, takes a large bite of stomach and exits the abdominal wall again more medially, then tied outside to keep the stomach retracted anteriorly.
Mobilization of the distal pancreas starts at its inferior margin.
The pancreas was only holding by a thin superior bridge of tissue at the transection site.
The transection was completed with the sealing device.
A Ray-Tec gauze is left at the site of transection to soak up any oozing that results during the remainder of the dissection.
The pancreas is elevated off the splenic vessels starting from the transection site and proceeding laterally.
The LigaSure serves as an excellent dissecting device, minimizing instrument exchange.
Each venous tributary to the pancreas is well skeletonized prior to ligation and division.
The inferior pole of the spleen was ischemic, but this had no clinical consequences.
The proximal pancreas is further mobilized for approximately 1 centimeter to allow for closure of the pancreatic duct using a vascular stapler.
A Jackson-Pratt drain is placed in the pancreatic bed, and fibrin sealant is injected over the staple line.
The patient was fed on the 2nd postoperative day.
The drain was removed on the 4th postoperative day.
The patient was discharged home on the 5th postoperative day.
Follow-up at one year continued to show an excellent outcome.