Fig. 4
From: Anterior approach in situ resection for total laparoscopic pancreaticoduodenectomy
The main operative procedure of laparoscopic pancreaticoduodenectomy via anterior approach. A Tumor was shown after completely taking down the hepatic flexure of colon and mesocolon transverse; B Post-pancreas tunnel was created; C The duodenum was transected by endoscopic stapler; D The gastroduodenal artery was transected; E The jejunum was transected with endoscopic stapler; F The pancreas neck was transected by ultrasonic scalpel; G The uncinate process of pancreas was dissected at the right side of superior mesenteric artery; H Anti-Kocher maneuver was carried out; I The tumor was resected and lymphadenectomy was carried out. T Tumor, P Pancreas, G Gallbladder, SMV Superior mesenteric vein, S Stomach, GDA Gastroduodenal artery, SMA Superior mesenteric artery, IVC Inferior vena cava, CHA Common hepatic artery