Minimal access distal pancreatectomy is now well established and in many centers the minimal access approach is the preferred route for this procedure. Laparoscopic resection of the neck, body, and tail of the pancreas corresponding to a subtotal pancreatectomy is the natural extension of the laparoscopic distal pancreatectomy.

Laparoscopic subtotal pancreatectomy is presented on a 63 year old male that presented with a complex cystic mass suspicious for malignancy in the body of the pancreas. A technique where the dissection is carried in a clockwise manner is presented. The dissection is started with takedown of the splenic flexure, exposure of the inferior edge of the pancreas from lateral to medial, division of the neck of the pancreas separating it from the superior mesenteric and portal veins, divsion of the splenic artery and vein, and dissection along the superior edge of the pancreas from medial to lateral to include an en bloc splenectomy.

The procedure was carried without intraoperative complications. The surgery lasted approximately two hours. Blood loss was less than fifty mililiters, and the patient recovered uneventfully. He was discharged home on post-operative day three.

Laparoscopic subtotal pancreatectomy is feasible and is likely to become the procedure of choice in selected patients.