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Laparoscopic adrenalectomy: A single center experience.

Kumar S, Bera MK, Vijay MK, Dutt A, Tiwari P, Kundu AK - J Minim Access Surg (2010)

Bottom Line: Serum corticosteroid levels were conducted in all, and urinary metanephrines, normetanephrines and VMA levels were performed in suspected pheochromocytoma.The patients were in the age range of 18-57 years, eleven males and nine females, seven right, eleven left, two bilateral.The mean operative time was 150 minutes (120-180), mean hospital stay four days (3-5), mean intraoperative blood loss 150 ml and mean post-operative analgesic need was for 36 (24-72) hours.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Institute of Post-Graduate Medical Education and Research (IPGMER) and Seth Sukhlal Karnani Memorial Hospital (SSKM), Kolkata - 700 020, India.

ABSTRACT

Aims: To evaluate the efficacy and safety of laparoscopic adrenalectomy in benign adrenal disorders.

Methods and material: Since July 2007, twenty patients have undergone laparoscopic adrenalectomy for various benign adrenal disorders at our institution. Every patient underwent contrast enhanced CT-abdomen. Serum corticosteroid levels were conducted in all, and urinary metanephrines, normetanephrines and VMA levels were performed in suspected pheochromocytoma. All the patients underwent laparoscopic adrenalectomy via the transperitoneal approach.

Results: The patients were in the age range of 18-57 years, eleven males and nine females, seven right, eleven left, two bilateral. The mean operative time was 150 minutes (120-180), mean hospital stay four days (3-5), mean intraoperative blood loss 150 ml and mean post-operative analgesic need was for 36 (24-72) hours. One out of twenty-two laparoscopic operations had to be converted into open adrenalectomy due to intra-operative complications.

Conclusions: Laparoscopic adrenalectomy is a safe, effective and useful procedure without any major post-operative complication and is the gold standard for all benign adrenal disorders.

No MeSH data available.


Related in: MedlinePlus

Dissecting adrenal gland tumour.
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Figure 0002: Dissecting adrenal gland tumour.

Mentions: Right adrenalectomy was usually performed with four ports. After making a skin incision, a primary Camera port 10 mm was placed about 3 cm lateral and cephalad to the umbilicus, using the close method. Two working ports, 5 mm and 10 mm were placed in the midclavicular position, the upper one (5 mm) below the costal margin, and the lower one (10 mm), 10-12 cm below the upper one. Another 5 mm port was placed in the sub-xiphisternal position for liver retraction. A fifth 5 mm port, if required, was placed in the right anterior line, to facilitate retraction. The right colon was mobilised along the line of Toldt. Via sub-xiphisternal port, the liver was retracted using a fan retractor and the triangular ligament was transected. The posterior peritoneum was incised along the surface of the liver, extending from the line of Toldt laterally, up to the inferior vena cava (IVC) medially. Subsequently, the duodenum was mobilised medially, to expose the renal hilum. Hepatodiaphragmatic attachments were identified and dissected. The right adrenal vein entering into the IVC was identified and isolated, and a hem-o-lok clip [Figure 1a] or Ligaclip (depending upon the need) was applied and transected. Subsequently, small superior and inferior adrenal vessels were coagulated and cut with LigaSure, completing the dissection of adrena gland tumour [Figure 1b]


Laparoscopic adrenalectomy: A single center experience.

Kumar S, Bera MK, Vijay MK, Dutt A, Tiwari P, Kundu AK - J Minim Access Surg (2010)

Dissecting adrenal gland tumour.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992657&req=5

Figure 0002: Dissecting adrenal gland tumour.
Mentions: Right adrenalectomy was usually performed with four ports. After making a skin incision, a primary Camera port 10 mm was placed about 3 cm lateral and cephalad to the umbilicus, using the close method. Two working ports, 5 mm and 10 mm were placed in the midclavicular position, the upper one (5 mm) below the costal margin, and the lower one (10 mm), 10-12 cm below the upper one. Another 5 mm port was placed in the sub-xiphisternal position for liver retraction. A fifth 5 mm port, if required, was placed in the right anterior line, to facilitate retraction. The right colon was mobilised along the line of Toldt. Via sub-xiphisternal port, the liver was retracted using a fan retractor and the triangular ligament was transected. The posterior peritoneum was incised along the surface of the liver, extending from the line of Toldt laterally, up to the inferior vena cava (IVC) medially. Subsequently, the duodenum was mobilised medially, to expose the renal hilum. Hepatodiaphragmatic attachments were identified and dissected. The right adrenal vein entering into the IVC was identified and isolated, and a hem-o-lok clip [Figure 1a] or Ligaclip (depending upon the need) was applied and transected. Subsequently, small superior and inferior adrenal vessels were coagulated and cut with LigaSure, completing the dissection of adrena gland tumour [Figure 1b]

Bottom Line: Serum corticosteroid levels were conducted in all, and urinary metanephrines, normetanephrines and VMA levels were performed in suspected pheochromocytoma.The patients were in the age range of 18-57 years, eleven males and nine females, seven right, eleven left, two bilateral.The mean operative time was 150 minutes (120-180), mean hospital stay four days (3-5), mean intraoperative blood loss 150 ml and mean post-operative analgesic need was for 36 (24-72) hours.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Institute of Post-Graduate Medical Education and Research (IPGMER) and Seth Sukhlal Karnani Memorial Hospital (SSKM), Kolkata - 700 020, India.

ABSTRACT

Aims: To evaluate the efficacy and safety of laparoscopic adrenalectomy in benign adrenal disorders.

Methods and material: Since July 2007, twenty patients have undergone laparoscopic adrenalectomy for various benign adrenal disorders at our institution. Every patient underwent contrast enhanced CT-abdomen. Serum corticosteroid levels were conducted in all, and urinary metanephrines, normetanephrines and VMA levels were performed in suspected pheochromocytoma. All the patients underwent laparoscopic adrenalectomy via the transperitoneal approach.

Results: The patients were in the age range of 18-57 years, eleven males and nine females, seven right, eleven left, two bilateral. The mean operative time was 150 minutes (120-180), mean hospital stay four days (3-5), mean intraoperative blood loss 150 ml and mean post-operative analgesic need was for 36 (24-72) hours. One out of twenty-two laparoscopic operations had to be converted into open adrenalectomy due to intra-operative complications.

Conclusions: Laparoscopic adrenalectomy is a safe, effective and useful procedure without any major post-operative complication and is the gold standard for all benign adrenal disorders.

No MeSH data available.


Related in: MedlinePlus