Retrograde distal pancreatectomy with splenectomy is the standard procedure for cancers of the body of the pancreas. However, it has limitations in terms of visibility, the posterior extent of resection, and the ability to achieve a complete N1 node resection. Low node counts and positive margins are common. This new procedure provides improved visibility by performing the dissection in antegrade manner. This entails early division of the neck of the pancreas and dissection from right-to-left. This step also permits early control of the vasculature and adjustment of the depth of the posterior extent of resection based on the CT scan and intraoperative findings. The posterior extent may either be ante or retro-adrenal. The node dissection is based on N1 lymph node drainage of the pancreas as described by O'Morchoe (Microscopy) Research & Technique 1997; 37: 456-77). It entails removal of the "ring" of nodes around the body and tail and the vertical chain along the left side of the celiac and the superior mesenteric arteries. Fifteen patients have had the procedure as shown in the video without mortality. The procedure shown was for an invasive neuroendocrine cancer. Associated Publication:Strasberg SM, Drebin JA, Linehan D. Radical antegrade modular pancreatosplenectomy. Surgery. 2003; 133: 521-7.