Moving to the inferior and posterior edge of the gland, dissection of the peripancreatic soft tissues continues until the confluence of the splenic vein and superior mesenteric vein (SMV) are visualized.
The inferior mesenteric vein is ligated and divided if it joins the splenic vein directly or if it interferes with ligation of the splenic vein close to the origin with the SMV; this is usually not the case.
Tissues around the entrance of the splenic vein into the SMV are carefully dissected off the vein.
A Satinsky, side-biting vascular clamp is placed on the superior mesenteric-portal vein junction; the splenic end of the splenic vein is tied with 2-0 suture.
The splenic vein is divided between ligature and clamp, being sure to leave the cuff of vein extending beyond the jaws of the clamp.
The proximal end of the splenic vein is oversewn with continuous 5-0 polypropylene suture and the vascular clamp then removed.
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