Abstract：
Radical modular antegrade pancreaticosplenectomy (RAMPS) improves posterior tumor-free margins during resections of pancreatic neoplasia involving the body or tail. However, minimally invasive RAMPS is technically challenging and has been reported seldom. We present for the first time a minimally invasive RAMPS technique with an innovative approach providing early dissection and control of the main peripancreatic vessels from an inframesocolic embryonal window, suitable for laparoscopy and robotics. Minimally invasive RAMPS with inframesocolic main pancreatic vessels-first approach was performed at the Tricase Hospital (Italy) from May 2017 to April 2022 in 11 consecutive patients with neoplastic lesions of the pancreas (8 laparoscopic RAMPS and 3 robotic RAMPS). Among the laparoscopic cases, 1 included a portal vein tangential resection and 1 a celiac artery resection (modified Appleby procedure). There were no conversions, no Clavien-Dindo complications > 2, all resections\' margins were tumor free, and no 90-day mortality.
摘要：
根治性模块化顺行胰脾切除术（RAMPS）在切除累及身体或尾巴的胰腺肿瘤时改善了无肿瘤的后缘。然而,微创RAMPS在技术上具有挑战性，很少有报道。我们首次提出了一种微创的RAMPS技术，该技术具有创新的方法，可从下结肠胚胎窗口早期解剖和控制主要胰周血管。适用于腹腔镜和机器人。2017年5月至2022年4月，在Tricase医院（意大利）对11例胰腺肿瘤病变的连续患者（8例腹腔镜RAMPS和3例机器人RAMPS）进行了以胰腺下结肠主血管优先入路的微创RAMPS。在腹腔镜病例中，1包括门静脉切向切除术和1腹腔动脉切除术（改良的Appleby程序）。没有转化，无Clavien-Dindo并发症>2,所有切除边缘无瘤,没有90天的死亡率。
