Direct image-guided retroperitoneal approach and treatment of the pancreas by using natural orifice transluminal endoscopic surgery after EUS sugar-assisted radiofrequency ablation (with video)

The pancreas is difficult to access surgically, and surgical procedures are often technically demanding and carry a high risk for adverse events. The main reasons are its retroperitoneal position and the surrounding vascular structures, which both result in difficult anterior access, as well as the challenging ductal reconstitution and anastomoses.