PANCREAS

A 59-year-old male presented an adenocarcinoma of the ampulla, which was found on an ERCP (Endoscopic Retrograde Cholangiopancreatography) for presumed gallstone pancreatitis.

This video includes discussion of imaging, a play-by-play of an open Whipple procedure (aka pancreaticoduodenectomy). Postoperative course and pathology are also included.

This video was produced by Drs. Brendan Visser, Juan Salazar, and Jon Harrison of Stanford University’s HPB surgery section.

A 73-year-old patient who presented with abdominal pain and weight loss. On preoperative CT scan there was evidence of a 4 cm pancreatic adenocarcinoma involving the celiac axis, encasement of the splenic artery and vein, with splenic vein thrombosis.

This video discusses imaging and gives a play-by-play of the appleby procedure. Postoperative course and pathology are also discussed.

This video was produced by Drs. Juan Salazar, Daniel Aliseda and Brendan Visser of Stanford University’s HPB Surgery Section.

Learn how to correctly set up a Bookwalter retractor during a Whipple Procedure. Our HPB Surgery team provides a step-by-step guide along with practical tips and tricks

This video was produced by Drs. Juan Salazar, Daniel Aliseda, Monica Dua, and Brendan Visser of Stanford University’s HPB Surgery Section.

Portal vein reconstruction during a Whipple procedure is one of the most challenging scenarios an HPB surgeon can face. Our HPB Surgery team provides a step-by-step guide, along with practical tips and tricks, for performing a patch reconstruction.

This video was produced by Drs. Juan Salazar, Daniel Aliseda, Monica Dua, and Brendan Visser of Stanford University’s HPB Surgery Section.

This is the case of a 58-year-old male who presented with severe acute necrotizing pancreatitis and developed walled-off pancreatic necrosis (WOPN) measuring approximately 20x8cm. Percutaneous aspiration of the collection was attempted twice at an outside facility.

This video discusses imaging and trocar placement and gives a play-by-play of the laparoscopic transgastric necrosectomy (TGN). Postoperative course is also discussed.

The video was produced by Drs. Brendan Visser, John Berquist, and Amy Li of Stanford University’s HPB surgery section.

This video shows a two-port minimally invasive retroperitoneal debridement. Imaging is also included.

This video was produced by Dr. Brendan Visser of Stanford University’s Division of General Surgery as well as Drs. Amy Li and Lindsay Sceats, who were general surgery residents, and Dr. John Bergquist, who was the HPB fellow at the time of filming.

An 81-year-old female presented with a side branch Intraductal Papillary Mucinous Neoplasm (IPMN) of the neck with progressive main pancreatic duct dilation. She had high risk of IPMN transformation on mutational analysis.

This video discusses imaging and trocar placement and gives a play-by-play of robotic central pancreatectomy with pancreaticogastrostomy. Postoperative course and pathology are also discussed.

This video was produced by Drs. Brendan Visser, Juan Salazar, and Jon Harrison of Stanford University’s HPB surgery section.

Situs inversus totalis (SIT) is a rare congenital condition where the thoracic and abdominal organs are arranged in a mirror image of the normal position

 A 78-year-old female with SIT presented with a main duct Intraductal Papillary Mucinous Neoplasm (IPMN).

This video discusses imaging, placement of trocars, and a play-by-play of a robotic Whipple procedure (aka pancreaticduodenectomy). Postoperative course and pathology are also discussed.

This video was produced by Drs. Brendan Visser, Juan Salazar, and Jon Harrison of Stanford University’s HPB surgery section.

An 80-year-old woman presented with a moderately differentiated pancreatic adenocarcinoma of the tail.

This video discusses chemotherapy and imaging, which led the team to perform a left subtotal pancreatectomy with en bloc resection of spleen, left adrenal, and tangential portion of the transverse color. The video discusses trocar placement and includes a play-by-play of the robotic radical antegrade modular pancreatosplenectomy (RAMPS). Postoperative course and pathology are also discussed.

This video was produced by Drs. Brendan Visser, Juan Salazar, and Jon Harrison of Stanford University’s HPB surgery section.

A 65-year-old male was followed with surveillance imaging for a cystic mass in the neck of the pancreas. After an interval increase of 1.3cm and finding clusters of malignant cells consistent with adenocarcinoma, a central pancreatectomy was planned.

The video discusses imaging and trocar placement and includes a play-by-play of the robotic surgery. As suspected, there was posterior invasion of the tumor into the portal vein, and it was therefore resected as well, and a bovine pericardial patch was placed. Postoperative course and pathology are also discussed.

This video was produced by Drs. Monica Dua and Brendan Visser of Stanford University’s Division of General Surgery HPB Section, along with Drs. Jonathan DeLong and Amy Li, who were the HPB Fellow and a General Surgery Resident, respectively at the time of filming.

A 72-year-old female presents with an Intraductal Papillary Mucinous Neoplasm (IPNM) at the head of the pancreas. A biopsy taken during endoscopic ultrasound showed invasive adenocarcinoma. The patient was taken for a robotic Whipple procedure after neoadjuvant chemotherapy.

This video discusses imaging, patient positioning, and trocar placement. Dr. Juan Salazar provides a play-by-play description of the pancreatic-duodenectomy and portal vein reconstruction using the DaVinci robot. Postoperative course and pathology are also discussed.

This video was produced by Drs. Juan Salazar, Daniel Aliseda, Jon Harrison, and Brendan Visser of Stanford University’s HPB Surgery Section.

A 61-year-old man presented with a 2-year history of recurrent hypoglycemia, confusion and fatigue; eating resulted in symptomatic resolution. A cross-sectional CT scan showed a 1.5cm mass within the uncinate. A fine-needle aspiration verified a well-differentiated neuroendocrine tumor.

The patient had been offered a pancreatic duodenectomy at two other academic medical centers. However, the Stanford team believed they could enucleate the lesion and spare the patient the morbidity of a Whipple.

This video discusses patient positioning and trocar placement. Dr. Amy Li provides a play-by-play of the robotic enucleation. Postoperative course and pathology are also discussed.

This video was produced by Drs. Xiaoluan Yan, Amy Li, Monica Dua, and Brendan Visser of Stanford’s Division of General Surgery.

A 17 year-old male presented with multiple endocrine neoplasia type 1. He was diagnosed with multiple pancreatic neuroendocrine tumors, with two dominant lesions on the body and head.

This video discusses imaging, trocar placement, and a play-by-play of the robotic central pancreatectomy with pancreatogastrostomy, as well as the robotic enucleation of a pancreatic head tumor. Postoperative course and pathology are also discussed.

This video was produced by Drs. Juan Salazar, Daniel Aliseda, Jon Harrison, and Brendan Visser of Stanford University’s HPB Surgery Section.

This video discusses in detail the surgical technique behind constructing a robotic pancreaticojejunostomy using a the Blumgart technique.

This video was produced by Drs. Johathan DeLong, Fari Ngongoni, Hester Timmerhuis, Cintia Kimura, David Hindin, Brooke Gurland, Monica Dua and Brendan Visser of Stanford University’s HPB Surgery Section.

A 74-year-old woman presented with main duct IPMN of the entire main pancreatic duct. Additionally, she had chronic pancreatitis.

This video discusses imaging, trocar placement, and a play-by-play of the robotic total pancreatectomy with Spleen/Vessel Preservation. Preparation for the islet cell harvest, hepaticojejunostomy, and duodenojejunostomy are also included.

Following isolation of the islets, the patient underwent islet autotransplantation (TPIAT). Postoperative course and pathology are also discussed.

This video was produced by Drs. Brendan Visser, Juan Salazar, and Daniel Aliseda of Stanford University’s HPB surgery section in conjunction with Dr. Vavara Kirchner of the Division of Abdominal Transplantation.