Laparoscopic pancreatoduodenectomy presents unique challenges including: (A) Kocher exposure of D3/D4; (B) uncinate dissection off of the superior mesenteric artery and vein; (C) identification and preservation of anatomic variations such as an aberrant course of the right hepatic artery; (D) difficult reconstruction. IVC, inferior vena cava; LOT, Ligament of Treitz; CBD, common bile duct; GDA, gastroduodenal artery; PV, portal vein; SMA, superior mesenteric artery; RHA, right hepatic artery.