Skip to main content

RAMPS Procedure for Adenocarcinoma of the Body and Tail of the Pancreas: How I Do It

  • Chapter
  • First Online:

Abstract

Radical antegrade modular pancreatosplenectomy (RAMPS) is performed for cancers of the body and tail of the pancreas which enables surgeons to achieve negative posterior margins more frequently than the traditional left-to-right surgical approach. However, determination of the superior mesenteric artery (SMA) involvement is impossible without first performing irreversible operative steps, despite the fact that SMA involvement generally indicates unresectable disease. SMA first approaches are operative tactics used to determine tumor resectability early during pancreatoduodenectomy. With locally advanced carcinoma of the pancreatic body and tail, early determination of SMA involvement also helps establish whether curative resection is feasible. We describe an inframesocolic SMA first approach as an introductory procedure when treating carcinoma of the pancreatic body and tail. This first approach procedure provides a reliable and safe introduction to RAMPS.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Strasberg SM, Linehan DC, Hawkins WG. Radical antegrade modular pancreatosplenectomy procedure for adenocarcinoma of the body and tail of the pancreas: ability to obtain negative tangential margins. J Am Coll Surg. 2007;204(2):244–9. https://doi.org/10.1016/j.jamcollsurg.2006.11.002.

    Article  PubMed  Google Scholar 

  2. Strasberg SM, Drebin JA, Linehan D. Radical antegrade modular pancreatosplenectomy. Surgery. 2003;133(5):521–7. https://doi.org/10.1067/msy.2003.146.

    Article  PubMed  Google Scholar 

  3. Kitagawa H, Tajima H, Nakagawara H, Makino I, Miyashita T, Terakawa H, Nakanuma S, Hayashi H, Takamura H, Ohta T. A modification of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the left pancreas: significance of en bloc resection including the anterior renal fascia. World J Surg. 2014;38(9):2448–54. https://doi.org/10.1007/s00268-014-2572-5.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kawabata Y, Hayashi H, Takai K, Kidani A, Tajima Y. Superior mesenteric artery-first approach in radical antegrade modular pancreatosplenectomy for borderline resectable pancreatic cancer: a technique to obtain negative tangential margins. J Am Coll Surg. 2015;220(5):e49–54. https://doi.org/10.1016/j.jamcollsurg.2014.12.054.

    Article  PubMed  Google Scholar 

  5. Bockhorn M, Uzunoglu FG, Adham M, Imrie C, Milicevic M, Sandberg AA, Asbun HJ, Bassi C, Buchler M, Charnley RM, Conlon K, Cruz LF, Dervenis C, Fingerhutt A, Friess H, Gouma DJ, Hartwig W, Lillemoe KD, Montorsi M, Neoptolemos JP, Shrikhande SV, Takaori K, Traverso W, Vashist YK, Vollmer C, Yeo CJ, Izbicki JR. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2014;155(6):977–88. https://doi.org/10.1016/j.surg.2014.02.001. [pii] S0039-6060(14)00050-6

    Article  PubMed  Google Scholar 

  6. Aosasa S, Nishikawa M, Hoshikawa M, Noro T, Yamamoto J. Inframesocolic superior mesenteric artery first approach as an introductory procedure of radical antegrade modular pancreatosplenectomy for carcinoma of the pancreatic body and tail. J Gastrointest Surg. 2016;20(2):450–4. https://doi.org/10.1007/s11605-015-3034-6.

    Article  PubMed  Google Scholar 

  7. Sato T, Saiura A, Inoue Y, Takahashi Y, Arita J, Takemura N. Distal pancreatectomy with En bloc resection of the celiac Axis with preservation or reconstruction of the left gastric artery in patients with pancreatic body cancer. World J Surg. 2016;40(9):2245–53. https://doi.org/10.1007/s00268-016-3550-x.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Suefumi Aosasa .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Aosasa, S., Nishikawa, M., Hoshikawa, M., Noro, T., Yamamoto, J. (2018). RAMPS Procedure for Adenocarcinoma of the Body and Tail of the Pancreas: How I Do It. In: Tewari, M. (eds) Surgery for Pancreatic and Periampullary Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7464-6_18

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-7464-6_18

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-7463-9

  • Online ISBN: 978-981-10-7464-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics