腹腔镜前RAMPS

                               
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Radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic body cancer.

Key steps
1. Divide gastrocolic omentum
2. Mobilise splenic flexure colon
3. Lymph node dissection - clear common hepatic and left gastric arteries
4. Dissection and division of splenic artery at its origin
5. Dissection of inferior border of pancreas
6. Develop tunnel between neck of pancreas and portal/superior mesenteric vein
7. Division of pancreatic neck (slow closure of vascular stapler)
8. Dissection and division of splenic vein
9. Dissection posteriorly along left side of superior mesenteric artery, extending deep to the anterior renal fascia to expose left renal vein
10. Mobilise specimen en bloc with anterior renal (Gerota's) fascia