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Ann R Coll Surg Engl. 2009 September; 91(6): 524–525.
PMCID: PMC2966222
Technical Notes and Tips
Bruce Campbell, Section Editor

The Use of Goldfinger™ (Ethicon Endo Surgery) to Facilitate Laparoscopic Distal Pancreatectomy

Laparoscopic distal pancreatectomy is a procedure that is gaining popularity in the management of both benign and malignant conditions of the pancreatic body and tail. A recent multicentre comparative study demonstrated that the procedure is associated with lower operative blood loss, fewer complications and shorter hospital stay without compromise of oncological margins when compared to the open procedure.1 One of the most challenging aspects of laparoscopic distal pancreatectomy is the dissection of the pancreas away from the portal vein at its confluence with the SMV and splenic vein. We describe a technique to facilitate laparoscopic distal pancreatectomy with a blunt dissector originally designed for the placement of laparoscopic gastric bands. Initially, a nylon tape is prepared by passing a braided suture through one end to form a loop (Fig. 1). The suture is then looped through the perforated end of the Goldfinger dissector. The Goldfinger is then introduced through a 5-mm working port and a tunnel is developed immediately anterior to the portal vein. The Goldfinger is ideal for this purpose as its tip can be angulated with ease and it has a blunt end. Once the distal end of the Goldfinger can be seen through the proximal end of the tunnel, the device is activated to allow upright angulation of its tip to reveal the tape through the tunnel. The retaining suture is divided and the tape is passed so as to completely sling the pancreatic neck away from the portal vein. This can then be used for retraction to complete the pancreatic dissection and stapling of the pancreatic neck without damaging the portal vein.

Figure 1
Preparation of the device.

Reference

1. Kooby DA, Gillespie T, Bentrem D, Nakeeb A, Schmidt MC, et al. Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg. 2008;248:438–46. [PubMed]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England