ABSTRACT
I. INTRODUCTION Laparoscopic staging of pancreatic cancer was first described almost two decades ago [l], but the application oflaparoscopic techniques to pancreatic surgery has developed slowly. Because of the location of the pancreas and the nature of the pancreatic tissues, advanced laparoscopic skills are required for alliaparoscopic pancreatic procedures. As laparoscopy has matured, several new technologies have allowed for a broader application of the minimally invasive approach to diseases of the pancreas. The most important is the use of intraoperative ultrasound with Doppler flow, which has allowed for detection of small lesions in the absence of palpation and for appreciation of the relationship between a mass and the ductal system. More recently, the development of hand-assist devices has encouraged the application of laparoscopy to more involved procedures and has provided a middle ground between laparoscopy and open surgery.
