SILS Pancreas Surgeries
The pancreas, situated in the abdomen, is a gland with dual functions in the digestive system. It produces enzymes and hormones to aid food digestion. These enzymes are sent into the small intestine, while insulin is released into the bloodstream to regulate glucose levels.
What is the Pancreas?
Acute Pancreatitis
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Upper abdominal pain
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Swollen and tender abdomen
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Nausea and vomiting
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Fever
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Increased Heart Rate
Chronic Pancreatitis
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Resemble acute pancreatitis
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Include persistent upper abdominal pain that can radiate to the back
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May be disabling in some cases
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Lead to weight loss
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May result in diabetes
Pancreatic Cancer in the body or tail
Pancreatic cancer in the body or tail of the pancreas typically manifests with abdominal and back pain, along with weight loss.
Pancreatic Cancer in the Pancreatic Head
Pancreatic cancer in the head of the pancreas commonly presents with symptoms including weight loss, jaundice, dark urine, pale stools, itching, nausea, vomiting, abdominal pain, and back pain.
Pancreatic Cancer & Digestive System
Symptoms may include darkening of urine, pale stools, diarrhea, nausea, abdominal bloating, and intermittent upper abdominal discomfort that radiates to the back.
Pancreatic Cancer and the Whole Body
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Weight Loss
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Malaise
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Loss of Appetite
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Elevated Blood Sugars, possibly Diabetes
Pancreatic Cancer and Skin
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Jaundice
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Dark Urine
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Light-colored Stools
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Itching
Islet Cell Tumors (Neuroendocrine Tumors)
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Account for only 1.5% of all pancreas tumors
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Abdominal pain
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Weight loss
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Nausea
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Vomiting.
Insulinomas (Excess Insulin)
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Sweating
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Anxiety
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Lightheadedness
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Fainting from low blood sugar
Glucagonomas (Excess Glucagon)
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Diarrhea
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Excessive Thirst or Urination
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Weight Loss
Gastrinomas (Excess Gastrin)
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Abdominal Pain
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Non-healing stomach ulcers
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Reflux
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Weight Loss
Somatostatinomas (excess somatostatin)
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Diarrhea
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Weight Loss
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Abdominal Pain
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Foul-smelling fatty stotols
VIPomas (Excess Vasoactive Intestinal Peptide)
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Abdominal Cramping
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Watery Diarrhea
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Facial Flushing
Signs & Symptoms
Pancreatitis
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Chronic pancreatitis is best diagnosed with tests that can evaluate the structure of the pancreas via radiography (x-ray exams)—blood tests are generally not helpful for making the diagnosis of chronic pancreatitis. As with acute pancreatitis, a doctor will conduct a thorough medical history and physical examinations.
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Trans-abdominal ultrasound: sound waves are sent toward the pancreas via a handheld device that a technician glides over the abdomen. The sound waves bounce off the pancreas, gallbladder, liver, and other organs, and their echoes generate electrical impulses that create an image—called a sonogram—on a video monitor. If gallstones are causing inflammation, the sound waves will also bounce off of them, showing their location.
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Endoscopic ultrasound: after spraying a solution to numb the patient’s throat, the doctor inserts an endoscope—a thin, flexible, lighted tube—down the throat, through the stomach, and into the small intestine. They then turn on an ultrasound attachment to the endoscope, which produces sound waves to create visual images of the pancreas and bile ducts.
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Magnetic resonance cholangiopancreatography (MRCP): MRCP uses magnetic resonance imaging (MRI), a non-invasive procedure that produces cross-section images of parts of the body. After being lightly sedated, the patient lies in a cylinder-like tube. The technician injects dye into the patient’s veins, which helps show the pancreas, gallbladder, and pancreatic and bile ducts.
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Computerized tomography (CT): A CT scan is a noninvasive radiograph (x-ray) that produces 3-dimensional images of parts of the body. The patient lies on a table that slides into a donut-shaped machine. The test can show gallstones and the extent of damage to the pancreas.
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Occasionally, blood tests, such as a test for IgG4 to assess for autoimmune pancreatitis, can be used to help diagnose the cause of chronic pancreatitis. However, blood tests are not typically used to make the diagnosis of chronic pancreatitis.
Pancreatic Cancer
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- Medical history, a doctor learns the story of the illness, such as the time of onset, nature and location of pain, smoking history, and other medical problems.
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Physical exam, a doctor might feel a mass in the abdomen and notice swollen lymph nodes in the neck, jaundiced skin, or weight loss.
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Lab tests may show evidence that bile flow is being blocked, or other abnormalities.
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Imaging Tests
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Computed Tormography (CT Scan)
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Magnetic Resonance Imaging (MRI)
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Ultrasound
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Positron Emission Tomography (PET Scan)
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If imaging studies detect a mass in the pancreas, a pancreatic cancer diagnosis is likely, but not definite. Only a biopsy can diagnose pancreatic cancer. Biopsies can be performed in several ways:
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Percutaneous needle biopsy: Under imaging guidance, a radiologist inserts a needle into the mass, capturing some tissue.
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Endoscopic retrograde cholangiopancreatography (ERCP): A flexible tube with a camera and other tools on its end (endoscope) is put through the mouth to the small intestine, near the pancreas.
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Endoscopic ultrasound: Similar to ERCP, an endoscope is placed near the pancreas. An ultrasound probe on the endoscope locates the mass, and a needle on the endoscope plucks some tissue from the mass.
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Laparoscopy is a surgical procedure that uses several small incisions. Using laparoscopy, a surgeon can collect tissues for biopsy, as well as see inside the abdomen to determine if pancreatic cancer has spread. However, laparoscopy has higher risks than other biopsy approaches.
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Diagnosis
The appendix is a narrow, small, finger-shaped portion of the large intestine that generally hangs down from (within) the lower right side of the abdomen
Appendicitis is a sudden inflammation of the appendix. Although the appendix does not seem to serve any purpose, it can become diseased and, if untreated, can rupture, causing infection and even death.
In rare cases, appendicitis may get better without surgery. Treatment might involve only antibiotics and a liquid diet. In most cases, however, surgery will be necessary.
The type of surgery will depend on the details of your case. If you have an abscess that hasn’t ruptured, you may receive antibiotics first. Your doctor will then drain your abscess using a tube placed through your skin. Surgery will remove your appendix after you’ve received treatment for the infection.
If you have a ruptured abscess or appendix, surgery may be necessary right away. Surgery to remove the appendix is known as an appendectomy. A doctor can perform this procedure as open surgery or through a laparoscopy.
Treatment Options
Treatment for appendicitis varies.
Pancreatitis
Inflammation of the pancreas requiring various treatments for symptom relief and recovery.
Hospitalization to Stabilize Pancreatitis
In severe cases, hospital care is necessary to stabilize the condition and manage symptoms effectively.
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Pain Medications
Pancreatitis can cause severe pain. Your health care team will give you medications to help control the pain.
Intravenous (IV) Fluids
Providing fluids through a vein helps maintain hydration and manage pancreatitis-related complications.
Treating the Underlying Cause of Pancreatitis
Addressing factors such as gallstones or alcohol consumption that trigger the condition.
Procedures to remove bile duct obstructions
Surgical interventions to clear blockages in the bile duct, often associated with pancreatitis.
Gallbladder surgery
Surgical removal of the gallbladder may be necessary, especially if gallstones contribute to pancreatitis.
Pancreas Surgery
Surgical procedures on the pancreas may be required in severe cases of pancreatitis.
Treatment for alcohol dependence
Addressing alcohol abuse, a common cause of chronic pancreatitis, is an essential part of management.
Additional Treatments for Chronic Pancreatitis
Options beyond addressing the primary cause, such as pain management and dietary modifications.
Treating the Underlying Cause of Pancreatitis
Once your pancreatitis is brought under control, your health care team can treat the underlying cause of your pancreatitis. Treatment will depend on the cause of your pancreatitis, but examples of treatment may include:
Pain Management
Strategies to alleviate pancreatitis-related pain, enhancing patient comfort and well-being.
Enzymes to Improve Digestion
Enzyme supplements aid in digestion when the pancreas is impaired, ensuring nutrient absorption.
Changes to your diet
Dietary adjustments are crucial for pancreatitis management, reducing stress on the pancreas and easing symptoms.
Treatment Options
Single Incision Laparoscopic Appendectomy (SILS Appendectomy) is performed through a single, small incision within the belly button. Camera and instruments are inserted through the same hole and surgery is conducted through the single hole. The infected specimen (appendix) is removed through the same hole. As the cut is closed with absorbable sutures, not visible on the outside, there are no obvious visible scars as the wound heals. There is also no need to remove any sutures.
Most cases of acute appendicitis can be treated by means of single incision laparoscopic surgery (SILS). The main advantages include:
