Laparoscopic / Minimally invasive Whipple surgery (pancreatico duodenectomy)

Pancreatoduodenectomy for pancreatic cancer / periampullary tumors is considered as one of the most challenging gastrointestinal & pancreatic surgery. While laparoscopic surgery / Minimally invasive surgery has settled as a routine for many other abdominal surgeries like gall bladder, appendix, colon, spleen etcetera; laparoscopic Whipple is still considered to be reserved for few specialist surgeons and centres in the world. We are proud to say that we are part of this select group of surgeons performing laparoscopic Whipple surgery in appropriately selected patients. We would like to showcase one such patient who recently underwent a laparoscopic Whipple surgery with us.

A 60 year old gentleman presented to us with obstructive jaundice due to a periampullary (ampullary) cancer. Patient already had a stent inserted in the bile duct for jaundice about 6 weeks prior at a rural center. The patient was fit for surgery and ideal for a laparoscopic Whipple, wherein the tumor is removed along with head of pancreas, entire duodenum, part of stomach & common bile duct. Patient underwent a laparoscopic Whipple surgery as planned and was discharged by 8th postoperative day.

Laparoscopic Whipple surgery is ideal in small tumors with dilated pancreatic and bile duct, without vascular involvement and without large lymph nodes.

Advantages of laparoscopic Whipple surgery

• Small incisions
• No cutting of muscles
• Less risk of incisional hernia
• Less pain
• Quicker mobilisation

Disadvantages / limitations

• May need longer operative time.
• Not suitable for all patients
• Does require at least a small incision to remove the specimen organs.
• Requires high level of laparoscopic surgical skills.