Objective:

To assess the feasibility and potential utility of patient-specific preoperative 3D reconstruction for surgical planning and intraoperative decision-making during laparoscopic distal pancreatectomy (LDP), focusing on spleen preservation strategies.

Approach:

• Study Design: Single-center prospective pilot case series involving two adult patients undergoing elective LDP.
• 3D Reconstruction Process: Preoperative CT and MRI were processed using dedicated segmentation software to generate patient-specific 3D models.

Key Findings:

• 3D reconstruction influenced preoperative surgical strategy regarding spleen management in both cases.
• In the first case, planned splenectomy was confirmed due to close tumor involvement with splenic vessels.
• In the second case, a spleen-preserving approach was supported by preserved separation from the vessels.
• Intraoperative findings confirmed the preoperative 3D assessment in both cases.
• Real-time consultation of the 3D model and intraoperative ultrasound facilitated safe dissection and pancreatic transection.
• Histology revealed well-differentiated neuroendocrine tumors in both patients.

Interpretation:

Limitations:

• The study is a pilot investigation with a small sample size of only two patients.
• No formal Institutional Review Board approval was required, which may limit generalizability.

Conclusion: