Selecting and Affixing loop of jejunum
A loop of jejunum has been selected and affixed to the greater curvature of the stomach, above the gastroepiploic vessels, with two stay sutures. Two enterotomies have been made and the stapling device inserted.
Lateral traction on the splenogastric attachments
Once the lesser sac has been entered, lateral traction on the splenogastric attachments will allow exposure of the short gastric vessels. These can be clipped (as shown) or divided with the LCS. (Reprinted with permission from Salky BA, Edye M. Laparoscop
Trocar Placement
Trocar placements for distal pancreatectomy. These sites are proper for both splenic salvage and with splenectomy. There should be at least a hand’s breadth distance between trocars 1, 3, and 4. The trocar for the laparoscope should be above the umbilicus