Dissection of lymph nodes around the common hepatic artery and celiac artery (Nos. 7, 8a, 9 Lymph Nodes)

Abstract

The pedicle of the left gastric artery and vein (gastropancreatic ligament) was carefully lifted using the right-hand grasper of the assistant, and the pancreas was carefully moved downward by the left-hand fan retractor or gauze of the assistant, which resulted in a good field of vision. The pancreatic capsule was dissected using Laparoscopic coagulating scissors (LCS) (Ethicon, Cincinnati, OH, USA) at the line of the superior pancreatic border toward the pancreatic tail as far as the root of the posterior gastric artery. Next, the common hepatic artery was exposed toward the root of the left gastric artery, and no. 8a lymph nodes and the right side of no. 9 lymph nodes were dissected by exposing the right border of the celiac artery (CHA) and crus with LCS and electrical cautery. In this step, the hepatic nerve plexus running along the CHA was preserved. © Springer 2012.