Laparoscopic adrenalectomy for benign adrenal tumors

Ishikawa, Tetsuro; Inaba, Masaaki; Nishiguchi, Yukio; Ishibashi, Rie; Ogisawa, Kana; Yukimoto, Kiyotaka; Ogawa, Yoshinari; Onoda, Naoyoshi; Hirakawa, Kosei; Chung, Yung-Khee

doi:10.1016/s0753-3322(00)80040-2

Cited by 17 publications

(13 citation statements)

References 7 publications

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“…Several studies show that with increased experience operating times continue to decrease 3,18,21,22,25 and, after the learning curve is completed, no evidence of any significant difference is found between LA and open surgery. Without compromising the functional outcome, LA proved to be a valid alternative, offering decreased analgesic requirements, less blood loss, shorter hospital stay and lower morbidity rates.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy

Assalia

Gautier

2004

British Journal of Surgery

311

209

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Despite a lack of a high level of evidence in its favour, LA has practically replaced OA in the management of small and medium-size benign functioning and non-functioning adrenal lesions, as it has proved to be as effective as OA with less associated morbidity. Although limited experience with large and malignant tumours shows some promise, present data are insufficient for clear conclusions to be drawn.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy

Assalia

Gautier

2004

British Journal of Surgery

311

209

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“…Here at Osaka City University Graduate School of Medicine, we have performed laparoscopic adrenalectomy in more than 150 cases in the last 10 years and found it useful and safe as compared to the conventional open surgery [9]. Operation time is not any longer compared with open surgery, and it is even shorter now after applying this technique as a routine procedure.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Adrenalectomy on a Patient with Primary Aldosteronism during Pregnancy

et al. 2006

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Abstract. A pregnant 26-year-old woman was referred for evaluation and management of progressive hypertension and hypokalemia at 14 weeks of gestation. Her plasma aldosterone level was markedly elevated and magnetic resonance imaging showed a right adrenal tumor. Primary aldosteronism due to an aldosterone producing-adenoma was diagnosed. Because of progressive severe hypertension, a laparoscopic adrenalectomy was performed at 17 weeks of gestation. The procedure was completed without complication, and plasma aldosterone and potassium levels rapidly improved postoperatively. However, her hypertension persisted and the growth retardation of the fetus was found. Regrettably, intrauterine fetal death was confirmed at 26 weeks of gestation. Histological examination of the placenta revealed that the placental artery had very thick walls which had apparently caused a critical failure in fetal blood flow. The optimal timing of laparoscopic surgery during pregnancy and perioperative management were subsequently discussed. PRIMARY aldosteronism is not a rare cause of hypertension [1], and its association with pregnancy has been reported. However, we found that only 23 cases have been described in the literature published in English since the first report of primary aldosteronism in pregnancy described by Crane et al. in 1964 [2]. A recent evolution in adrenal surgery, including minimally invasive laparoscopic surgery, has largely improved modality and QOL of patients with primary aldosteronism. As of yet, however, there has been little discussion of performing laparoscopic adrenalectomy on a pregnant woman. We report a case of primary aldosteronism during pregnancy that was treated by a laparoscopic adrenalectomy and discuss the feasibility of this procedure on pregnant women. Case ReportA 26-year-old Japanese woman was hypertensive when she registered for prenatal care at 14 weeks and 4 days of gestation. She had been healthy before becoming pregnant; however, the initial laboratory assessment revealed low potassium and high plasma aldosterone levels. She was told three years ago that she had mild hypertension that could be controlled

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“…The ultrasonic scalpel functions by creating high-frequency longitudinal blade vibrations, generating heat that achieves tissue destruction with less smoke and char then conventional electrocautery. Many surgeons have confirmed the efficacy of the ultrasonic scalpel for reducing the amount of bleeding when used to perform PA of adrenal adenomas or pheochromocytomas [14][15][16]25,27,29].…”

Section: Surgical Techniquesmentioning

confidence: 98%

“…Ishikawa et al's [16] series of transperitoneal LPAs similarly reported on the feasibility of this procedure, and the authors noted a shorter mean operative time of 92 minutes compared with 154 minutes for TA. More recently, Kok and Yapp [17] performed a 2-year prospective review of eight patients with primary hyperaldosteronism due to APA who underwent transperitoneal LPA.…”

Section: Adrenal Adenomamentioning

confidence: 99%

“…The vascular stapler is another instrument that provides excellent hemostasis during PA, although it lacks the precision of sutures or the ultrasonic scalpel [16,17,30]. Imai et al [31] were able to excise lesions with a 5-mm margin of normal tissue in five patients when lesions were in the superior or inferior portions of the adrenal gland.…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Adrenal-preserving minimally invasive surgery: The role of laparoscopic partial adrenalectomy, cryosurgery, and radiofrequency ablation of the adrenal gland

2003

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Adrenalectomy has become the standard of care for the management of hormonally active adrenal masses. Various surgical therapies have been proposed to excise completely or destroy these adrenal lesions, which may be benign or malignant. New minimally invasive, adrenal-sparing procedures have recently been introduced, among them laparoscopic partial adrenalectomy, cryosurgery, and radiofrequency ablation. These procedures focus on reducing patient morbidity and hastening postoperative recovery while preserving normal adrenal tissue. However, questions remain about the risks and benefits associated with routine application of minimally invasive therapies for adrenal-sparing surgery in terms of complete tumor extirpation. Clearly, more experience and longer follow-up is necessary to validate these procedures. Herein we describe the surgical techniques and early results of treatment with adrenal-sparing surgery.

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Laparoscopic adrenalectomy for benign adrenal tumors

Cited by 17 publications

References 7 publications

Laparoscopic adrenalectomy

Laparoscopic adrenalectomy

Laparoscopic Adrenalectomy on a Patient with Primary Aldosteronism during Pregnancy

Adrenal-preserving minimally invasive surgery: The role of laparoscopic partial adrenalectomy, cryosurgery, and radiofrequency ablation of the adrenal gland

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