**New Surgical Procedure for Pancreas Head New Surgical Procedure for Pancreas Head**

Yoshinobu Sato, Yoshiaki Hara, Naruhiko Sawada, Shoji Shimada, Kenta Nakahara, Daisuke Takayanagi, Fumio Ishida, Shin-EI Kudo and Junichi Tanaka Yoshinobu Sato, Yoshiaki Hara, Naruhiko Sawada, Shoji Shimada, Kenta Nakahara, Daisuke Takayanagi, Fumio Ishida, Shin-EI Kudo and Junichi Tanaka

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/66493

#### **Abstract**

In this study, we demonstrate two new methods for pancreaticoduodenectomy (PD). One method is the mini‐laparotomic PD by Shuriken‐shaped umbilicoplasty with the real‐time moving window's method. The other method is the new pancreaticojejunostomy (PJ) by punctured stent slide guiding method (PSSGM). This procedure could be performed by complete mini‐laparotomy under direct vision, and the final major wound is only 2 cm of round navel. PSSGM prevents the difference of caliber between pancreatic anastomosis and the inside out of jejunal mucosa in theory. Ten cases of mini‐lap PD were successfully performed under new PJ anastomosis. The pancreatic leakage (PL) was only one case of ISGPF grade A, and its frequency was 9% (1/11). Our mini‐lap PD by Shuriken‐shaped umbilicoplasty might be a useful way for overcoming the obstacles about safety, compli‐ cation risk, cosmetic demand, and medical cost compared to laparoscopic PD. Also, our new device of PJ reconstruction by PSSGM might be an easy and useful device for the prevention of PL.

**Keywords:** laparoscopic pancreaticoduodenectomy, pancreaticojejunostomy, navel surgery, Shuriken‐shaped umbilicoplasty, minimal invasive surgery
