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. 2007;9(2):156-9.
doi: 10.1080/13651820701225688.

Videoscopic assisted retroperitoneal debridement in infected necrotizing pancreatitis

H C van Santvoort  1 , M G H Besselink, K D Horvath, M N Sinanan, T L Bollen, B van Ramshorst, H G Gooszen; Dutch Acute Pancreatis Study Group
Affiliations

Videoscopic assisted retroperitoneal debridement in infected necrotizing pancreatitis

H C van Santvoort et al. HPB (Oxford). 2007.

Abstract

Surgical intervention in patients with infected necrotizing pancreatitis generally consists of laparotomy and necrosectomy. This is an invasive procedure that is associated with high morbidity and mortality rates. In this report, we present an alternative minimally invasive technique: videoscopic assisted retroperitoneal debridement (VARD). This technique can be considered a hybrid between endoscopic and open retroperitoneal necrosectomy. A detailed technical description is provided and the advantages over various other minimally invasive retroperitoneal techniques are discussed.

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Figures

Figure 1.
Figure 1.
A percutaneous catheter drain is positioned in the collection through a left retroperitoneal approach.
Figure 2.
Figure 2.
A 5 cm subcostal incision is placed in the patient's left flank.
Figure 3.
Figure 3.
The first necrosis is removed with a grasping forceps.
Figure 4.
Figure 4.
A videoscope is inserted and residual necrosis is removed with a laparoscopic grasping forceps. A single trocar is used.
Figure 5.
Figure 5.
VARD allows for large pieces of necrosis to be removed.
See this image and copyright information in PMC

References

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