Abstract:Minimally access retroperitoneal pancreatic necrosectomy (MARPN) is a minimally invasive surgical approach for the treatment of infected pancreatic necrosis (IPN), in which necrotic tissue behind the peritoneum and around the pancreas is cleared using visualized equipment such as nephroscope or flexible endoscope, with the sinus tract as the surgical pathway. However, its popularity still needs to be improved, and further research and discussion are needed on its indications, specific technical details, and postoperative management. In some large-scale pancreatic surgery centers at home and abroad, including the authors' center, MARPN has become the main means of treating IPN, and from the published data, it has shown good therapeutic effects. After years of exploration and practice, the authors' center has accumulated a large number of cases and experiences in MARPN surgery and standardized the steps, procedures, and technical details of the surgery. Here, the authors introduce the operative technique and perioperative management of MARPN, hoping to promote the wider, safer, and more effective implementation of this technique.