Laparoscopic surgery is applicable for larger mucinous cystic neoplasms of the pancreas.

BACKGROUND: Mucinous cystic neoplasms (MCN) of the pancreas frequently develop in the distal pancreases of young women. Laparoscopic surgery can enhance cosmetic benefits and ease of surgery. This study assessed the feasibility of laparoscopic surgery for MCN. METHODS: The medical records of 21 patients pathologically diagnosed with benign MCN after laparoscopic resection were reviewed. Clinical data were compared in the 11 patients with tumors ≥ 45 mm (large tumor group) and the 10 patients with tumors < 45 mm (small tumor group). RESULTS: Laparoscopic resection was completed in all patients, including distal pancreatectomy with (n = 9) and without (n = 11) spleen preservation and enucleation for pancreatic head lesion (n = 1). Operation time, blood loss, postoperative morbidity, and hospital stay were similar in the two groups. Spleen-preserving pancreatectomy could be more frequently completed in the small MCN group (P = 0.02). No recurrence was observed during a median follow-up period of 12 months. CONCLUSIONS: Laparoscopic surgery can be completed in all patients with benign MCN, even those with large tumors, and patients with small MCN can get the additional benefit of spleen preservation.

Single-incision laparoscopy-assisted surgery for bowel obstruction: report of three cases.

We applied single-incision laparoscopy-assisted surgery for several different types of bowel obstruction in selected patients. Before the operation, a long nasal tube was inserted for intestinal decompression and assessment of a stenotic lesion. A specially-designed instrument for single-incision laparoscopic surgery, the SILS Port, was introduced at the umbilicus or proposed ileostomy site. After intracorporeal procedures, extracorporeal resection and reconstruction of the intestine was performed as needed. Three patients with bowel obstruction due to jejunal carcinoma, colonic stenosis, and adhesion underwent single-incision laparoscopy-assisted surgery. The port site was used for subsequent extracorporeal resection and anastomosis of the jejunum in two patients, and for ileostomy in the remaining patient. All of the procedures were completed safely, and there were no postoperative complications. Single-incision laparoscopy can therefore be applied for selected patients with bowel obstruction. In such cases, the preoperative insertion of a long nasal tube for decompression of intestinal contents and assessment of the stenotic lesion is necessary.