Laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection is still difficult to accomplish,which restrains its application in total gastrectomy for advanced proximal gastric cancer.Based on our anatomical understanding of pre- and retropancreatic spaces,features of splenic vessels and distribution of perigastric lymph nodes,we combined the characteristics of laparoscopic surgery and developed a novel technique for laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection through retropancreatic space.The key lies in mobilization of the splenic pedicle through retropancreatic space,dissection of peri-vascular lymph nodes in sequence of trunk-to-branch,in-sheath vascularization of the splenic vessels.From August 2009 to December 2010,this technique was performed on 6 patients in Nanfang hospital.The initial results suggested that this technique could be safe and feasible for skillful surgeons.Further studies on the application of this technique in total gastrect

作者：李国新；牟廷裕；余江；王亚楠；胡彦锋

来源：中华消化外科杂志 2012 年 11卷 1期