Laparoscopic observation and biopsy of the pancrease.

Laparoscopy has been employed mainly in liver diseases. Although there have been many reports dealing with intraabdominal lesions other than those of the liver, there have been few concerning the pancreas. Because of its anatomical characteristics, the laparoscopic approach to the pancreas has been extremely difficult. For endoscopic diagnosis of pancreatic lesions, we have developed a 2-channel operating laparoscope. Using a supragastric approach through the lesser omentum, the scope is inserted into the lesser peritoneal sac for direct inspection of the pancreas. In this paper, the method of lesser omentotomy and the diagnostic results are described.