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Transperitoneal laparoscopic adrenalectomy in children.

Catellani B, Acciuffi S, Biondini D, Ceccarelli PL, Cacciari A, Gelmini R - JSLS (2014 Jul-Sep)

Bottom Line: The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.None of the patients showed signs of recurring disease at 15-month follow-up.It also provides good visibility and easy access to other organs.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery.

ABSTRACT

Purpose: The use of a minimally invasive approach for adrenalectomy is poorly defined in pediatric patients, although laparoscopic adrenalectomy is considered a standard procedure in adults. The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.

Materials and methods: This was a retrospective study of 4 pediatric laparoscopic adrenalectomies performed at our center between 2009 and 2012. All patients underwent transperitoneal lateral laparoscopic adrenalectomies (2 right and 2 left adrenalectomies).

Results: Four laparoscopic adrenalectomies were performed. Indications for surgery were neuroblastoma in 2 patients, secernent adrenocortical tumor in 1 patient, and adrenocortical nodular hyperplasia in 1 patient. Patients had a mean age of 87 months (range, 17-156 months) at diagnosis, and the average lesion size was 3.23 cm (range, 0.7-6.4 cm). All laparoscopic adrenalectomies were successful, no conversions to open surgery were required, and no postoperative complications or deaths occurred. The average operating time was 105 minutes (range, 80-130 minutes), blood loss during surgery was minimal, and the mean postoperative hospital stay was 3.75 days (range, 3-5 days). None of the patients showed signs of recurring disease at 15-month follow-up.

Conclusions: Laparoscopic adrenalectomy is a safe, feasible, and reproducible technique offering numerous advantages, including shortening of operating times and postoperative hospital stays, as well as reduction of blood loss and complications. It also provides good visibility and easy access to other organs.

No MeSH data available.


Related in: MedlinePlus

Dissection of the left adrenal vein.
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Figure 6: Dissection of the left adrenal vein.

Mentions: A plane along the anterior surface of the kidney, lateral and dorsal to the spleen and tail of pancreas, was established, and the splenocolic and spleen's suspensory ligaments were divided to expose the adrenal gland. The dissection proceeded along the anterior surface of the kidney and adrenal gland until the inferior and medial border. Afterward, the splenic vein was identified and followed to identify the left renal vein, the left adrenal vein, and the left adrenal artery. The main adrenal vessels were isolated and sectioned with a vessel-sealing device (Figure 6). The dissection proceeded in a superior and lateral direction until the complete mobilization of the adrenal gland. The specimen was removed intact within an endosurgical bag, through a periumbilical port, enlarged when necessary. The surgery finished as on the right side.


Transperitoneal laparoscopic adrenalectomy in children.

Catellani B, Acciuffi S, Biondini D, Ceccarelli PL, Cacciari A, Gelmini R - JSLS (2014 Jul-Sep)

Dissection of the left adrenal vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4208910&req=5

Figure 6: Dissection of the left adrenal vein.
Mentions: A plane along the anterior surface of the kidney, lateral and dorsal to the spleen and tail of pancreas, was established, and the splenocolic and spleen's suspensory ligaments were divided to expose the adrenal gland. The dissection proceeded along the anterior surface of the kidney and adrenal gland until the inferior and medial border. Afterward, the splenic vein was identified and followed to identify the left renal vein, the left adrenal vein, and the left adrenal artery. The main adrenal vessels were isolated and sectioned with a vessel-sealing device (Figure 6). The dissection proceeded in a superior and lateral direction until the complete mobilization of the adrenal gland. The specimen was removed intact within an endosurgical bag, through a periumbilical port, enlarged when necessary. The surgery finished as on the right side.

Bottom Line: The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.None of the patients showed signs of recurring disease at 15-month follow-up.It also provides good visibility and easy access to other organs.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery.

ABSTRACT

Purpose: The use of a minimally invasive approach for adrenalectomy is poorly defined in pediatric patients, although laparoscopic adrenalectomy is considered a standard procedure in adults. The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.

Materials and methods: This was a retrospective study of 4 pediatric laparoscopic adrenalectomies performed at our center between 2009 and 2012. All patients underwent transperitoneal lateral laparoscopic adrenalectomies (2 right and 2 left adrenalectomies).

Results: Four laparoscopic adrenalectomies were performed. Indications for surgery were neuroblastoma in 2 patients, secernent adrenocortical tumor in 1 patient, and adrenocortical nodular hyperplasia in 1 patient. Patients had a mean age of 87 months (range, 17-156 months) at diagnosis, and the average lesion size was 3.23 cm (range, 0.7-6.4 cm). All laparoscopic adrenalectomies were successful, no conversions to open surgery were required, and no postoperative complications or deaths occurred. The average operating time was 105 minutes (range, 80-130 minutes), blood loss during surgery was minimal, and the mean postoperative hospital stay was 3.75 days (range, 3-5 days). None of the patients showed signs of recurring disease at 15-month follow-up.

Conclusions: Laparoscopic adrenalectomy is a safe, feasible, and reproducible technique offering numerous advantages, including shortening of operating times and postoperative hospital stays, as well as reduction of blood loss and complications. It also provides good visibility and easy access to other organs.

No MeSH data available.


Related in: MedlinePlus