Laparo-Endoscopic Single Site Anatomical Retroperitoneoscopic Adrenalectomy Using Conventional Instruments: Initial Experience and Short-Term Outcome
| Autor: | Hong-Zhao Li, Baojun Wang, Xin Ma, Taoping Shi, Xu Zhang |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Urology medicine.medical_treatment Adrenal Gland Neoplasms Blood Loss Surgical Statistics Nonparametric Adipose capsule of kidney Cohort Studies Port (medical) medicine Humans Minimally Invasive Surgical Procedures Retroperitoneal space Retroperitoneal Space Laparoscopy Aged Pain Measurement Chi-Square Distribution medicine.diagnostic_test business.industry Adrenalectomy Endoscopy Fascia Length of Stay Middle Aged Surgery Dissection Treatment Outcome medicine.anatomical_structure Female business Follow-Up Studies |
| Zdroj: | Journal of Urology. 185:401-406 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | To our knowledge we present the initial experience with and the short-term outcome of laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy using conventional instruments.Between June 2009 and April 2010, 25 patients underwent laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy. A TriPort™ Access System was inserted through a 2.5 to 3.0 cm transverse skin incision below the tip of the 12th rib. Adrenalectomy was done using a 5 mm 30-degree laparoscopic camera and 2 conventional laparoscopic instruments. After Gerota's fascia was incised we explored the first dissection plane between the perirenal fat and the anterior renal fascia at the superomedial side of the kidney. The adrenal gland was identified at the initial stage of the operation.Laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy was successfully accomplished in 23 patients. An additional 5 mm port was required in 1 of the 2 unsuccessful cases and in the other it was necessary to convert to standard anatomical retroperitoneoscopic adrenalectomy. Median incision length was 3.0 cm, median operative time was 55 minutes and median estimated blood loss was 15 ml. No major intraoperative complications occurred. In the initial 10 cases median operative time was significantly longer (62 vs 50 minutes) and median blood loss was significantly higher (75 vs 10, each p0.001) than in the subsequent 15. In 3 cases pheochromocytoma was successfully excised without undesirable hemodynamic oscillation. Postoperative complications developed in 2 patients, including angina and contralateral atelectasis in 1 each.In properly selected patients laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy with conventional instruments is feasible, safe and effective, causes minimal morbidity and results in excellent cosmesis. |
| Databáze: | OpenAIRE |
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