Laparoscopic Blumgart-style two-layer anastomosis without stent

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  • Technique Description

    • This reconstruction technique is inspired by the open Blumgart pancreaticojejunostomy, and has been modified to fit the constraints of the laparoscopic field.
    • The principle of this technique is to utilize trans-pancreatic sutures to create an invagination of the small bowel, which encapsulates the pancreas parenchyma, and the duct-to-mucosa anastomosis, on the anti-mesenteric side of the bowel.
    • Trans-pancreatic sutures are placed through the full thickness of the pancreas to prevent pancreas capsule tearing and relieve tension on the duct-to-mucosa anastomosis.
    • All knots on the outer layer of the anastomosis are tied on the anterior surface of the pancreas facilitating easier laparoscopic suturing.
  • Special Acknowledgement

    • This video was a collaboration project with Dr. Shiva Jayaraman at St. Joseph's Health Centre.
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