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matter of equipment availability and personal preference. This video shows how transection can be performed with the use of a single disposable device, the ultrasonic scalpel. Dissection can be performed opening the jaw, exposing the active blade and moving the tip sideways, without pressure on vessels and without blind insertion inside the parenchyma. Vessel sealing is applied with the common use of the equipment, closing the tip around the dissected vessel (after hemostatic clips when needed). Three short videos are shown:

The impact of perioperative immunonutrition in pancreatic cancer surgery remains controversial. While some studies have demonstrated a positive impact on outcomes in well-nourished patients, others showed no difference in outcomes. In a recent study examining the effects after pancreatic and gastric cancer surgery, benefits were only identified in malnourished patients. Our goal was to assess the effect of perioperative immunonutrition on the surgical outcomes of patients undergoing pancreatic cancer resections in our institution. Methods: A retrospective review of a prospectively collected database of 101 consecutive patients undergoing surgery for suspected pancreatic malignancy in our centre over an eight-year period was conducted. The demographics, nutritional status, and other relevant endpoints such as grade of surgical complications and length of stay were obtained. Results: 8 patients with benign final histology were excluded. Patients with incomplete data on immunonutrition were also excluded from the final analysis. 36 patients received perioperative immunonutrition while 43 patients did not. There was no statistically significant difference in the infective complications between the two groups and the severity of complications including the median lengths of stay were also similar in both groups. Conclusion:The efficacy of immunonutrition in improving the outcomes of pancreatic cancer resections remains to be proven. Our project is an example of early collaboration with allied health team to improve the outcomes of pancreatic cancer. Given the small sample size of our study and other limitations, further investigations are required to answer this pertinent question.

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