Laparoscopic RAMPS is a challenging procedure conducted for Adenocarcinoma of Body and tail of pancreas. A 70yr lady presented with pain abdomen and worsening diabetes. On Evaluation with PET Scan, she was found to have 2.5cm mass in mid body of pancreas. It was diagnosed as Adenocarcinoma of pancreas localised to pancreas. The tumour was infiltrating spleno-portal vein axis. There was no arterial involvement. After reviewing the reports, she was considered for upfront surgery. On demand, the challenging laparoscopic surgery was considered.
She underwent Laparoscopic RAMPS with vein reconstruction totally laparoscopically. She recovered well after surgery and the Final HPE was R0 resection with adenocarcinoma pancreas T3N0M0. After complete recovery She is advised chemotherapy. The RAMPS is a challenging procedure involves lymphadenectom around both Celiac and SMA vessels and spleno-portal axis, can cause bleeding catastrophe perioperatively. Its even more challenging to perform it laparoscopically. We could successfully perform this procedure laparoscopically without blood transfusion and good oncological outcome.
