A new in situ anterior technique for dissecting the superior mesenteric artery (SMA) during laparoscopic pancreaticoduodenectomy improves outcomes.

• Operative time averaged 340 minutes with a blood loss of 200 ml.
• Patient had no complications, including pancreatic fistula, and was discharged on postoperative day 8.

This technique minimizes tension on mesenteric vessels, reducing the risk of accidental bleeding.

• Histological results confirmed poorly-differentiated biliary adenocarcinoma without lymph node involvement.