Typically, five ports are used for this procedure, placed as indicated in Fig. 72.1A. Introduce the laparoscope through a slightly supraumbilical port to facilitate visualization of the left upper quadrant. After thoroughly exploring the abdomen, create an opening in the lesser sac by detaching the gastrocolic omentum from the greater curvature of the stomach using ultrasonic shears. Continue the division proximal and distal along the greater curvature until a sufficiently large window has been developed to allow the stomach to be reflected cephalad, exposing the pancreas and splenic artery (Fig. 72.1B). Divide any filmy adhesions between posterior gastric wall and retroperitoneum with the ultrasonic scalpel. Identify the region of interest. The splenic vein lies behind the pancreas and will not generally be seen (Fig. 72.1C). Laparoscopic ultrasound may assist in identifying abnormalities that are not visually evident. Determine the site of proposed transection of the pancreas.