OBJECTIVE: The aim of this video is to present a laparoscopic Kimura distal pancreatectomy step by step. The spleen-preserving distal pancreatectomy with conservation of the splenic vessels also known as the Kimura technique was first described in 1996 and is along with the Warshaw technique one of the two techniques that allow for spleen preservation in distal pancreatectomies. The reason why spleen preservation is important is the postoperative morbidity reduction in terms of lowering thrombotic and septic risks.

METHODS: A 55 year-old female patient previously operated on for a retrocolic retrogastric gastric bypass was diagnosed with a cystic tumor in the tail of the pancreas. A rapid growth was noticed two years later and the patient became symptomatic. We decided to perform a laparoscopic distal pancreatectomy with preservation of spleen & splenic vessels.

RESULTS: The postoperative course was without complications. Enteral nutrition was started on day 1 and a dosage of the serum and drainage amylase was performed on the 3rd postoperative day showing no fistula. The patient was discharged on the 4th postoperative day.

CONCLUSIONS: The Kimura procedure offers the advantage of decreased morbidity in an oncologic resection setting but in order to be performed under laparoscopy it requires both pancreatic and laparoscopic expertise.