Whipple Procedure Reconstruction

Whipple Procedure Reconstruction

This illustration was created as part of our Surgical Illustration II course, which involved viewing a complex and/or laparoscopic procedure of our choosing, describing it through a series of sketches, and selecting one or more sketches to render and format as a presentation slide.

I viewed multiple laparoscopic Whipple procedures by Dr. Jin He, consulted with Dr. He and my faculty advisor, Jennifer Fairman, about my sketches, refined them, and chose part of the pancreaticojejunostomy to render.

You can view the full series, as shown at the Class of 2026 Surgical Illustration Presentation, below.

2025

Johns Hopkins School of Medicine

Jeni Fairman, Dr. Jin He

Adobe Photoshop

Presentation Recording

overview

Overview of anatomy to be resected, and anatomy after specimen retrieval.

diagram

Diagram of jejunum mobilization and completed reconstruction.

ports

Four 8mm ports for Da Vinci robot and central 12mm port for assisting surgeon.

1

1: Jejunum mobilized through Ligament of Treitz defect.

2a

2A: Pancreas and Jejunum approximated

2b

2B: Jejunotomy created and mucosa pulled through

2c

2C: Duct and mucosa approximated posteriorly; feeding tube placed as stent

2d

2D: Anastomosis completed with a double layer of prolene sutures

2e

2E: Anastomosis secured with v-loc suture

3a

3A: Jejunotomy created 4cm from the pancreaticojejunostomy

3b

3B: Jejunotomy and common hepatic duct approximated posteriorly

3c

3C: Pediatric feeding tube placed as stent

3d

3D: Anastomosis completed anteriorly with a single layer

4a

4A: Viable tissue flap attached to Ligament Teres passed behind the Common Hepatic Artery to wrap the stump of the Gastroduodenal Artery.

4b

4B: Tissue flap wrapped around GDA stump and sutured to itself

4c

4C: GDA wrap tucked behind jejunum

5a

5A: Jejunum brought anterior to colon ~40cm distal to hepaticojejunostomy

5b

5B: Gastrostomy and jejunostomy created; stomach mucosa sutured to serosa

5c

5C: Stomach and jejunum anastomosed using Endo GI stapler

5d

5D: Anastomosis closed with a double layer of sutures

5e

5E: Sutures in progress

5f

5F: Sutures completed

finished

Finished reconstruction

summary

Whipple procedure summary