Retroperitoneal Laparoendoscopic Single-Site Adrenalectomy: Our Initial Technical Experience

Luo, Yongwen; Chen, Xiang; Chen, Zhi; He, Yongzhong; Li, Nannan; Lai, Cheng; Xie, Chao-Qun

doi:10.1089/lap.2011.0468

Cited by 7 publications

(2 citation statements)

References 15 publications

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“…On the issue of what is the preferred equipment for LESS, one can conclude that the spectrum of specialised systems for LESS surgery from different companies is broad [ 7 , 31 ]. We have found in the literature attempts to perform LESS AE with conventional ports and instruments labelled by some authors as “home-made” [ 3 , 12 , 32 , 33 ]. In our view, it is important to choose a system that requires only a short incision.…”

Section: Discussionmentioning

confidence: 99%

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Hora¹,

Ürge²,

Stránský³

et al. 2014

Videosurgery and Other Miniinvasive Techniques

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IntroductionAt our institution, laparoendoscopic single-site surgery (LESS) has been established as a technique for laparoscopic nephrectomy since 2011, and since 2012 in selected cases for adrenalectomy (AE) as well.AimTo compare LESS AE with standard laparoscopic AE (SLAE).Material and methodsBetween 3/2012 and 7/2014, 35 adrenalectomies were performed. In 18 (51.4%), a LESS approach was chosen. Indications were strictly non-complicated cases (body mass index (BMI) < 34 kg/m2, tumour ≤ 7 cm, non-malignant aetiology, no previous surgery). All LESS procedures were done by one surgeon. Standard equipment was a 10 mm rigid 0° camera, Triport+, one pre-bent grasper, and a sealing instrument. The approach was pararectal in all cases except one (transumbilical in a slim man). Three patients with LESS were excluded (2 partial AEs only, one adrenal cancer converted to SLAE and then to open surgery). These 15 LESS AE procedures were compared to 15 SLAEs with similar characteristics chosen among 54 SLAEs performed in the period 1/2008–2/2012.ResultsIn 8 cases (53.3%) of LESS AE, a 3 mm port was added to elevate the liver/spleen. Mean parameters of LESS AE vs. SLAE (Wilcoxon test): maximal tumour diameter 43.7 mm vs. 36.1 mm (p = 0.28), time of surgery 63.3 min vs. 55.3 min (p = 0.22), blood loss 38.0 ml vs. 38.0 ml (p = 0.38), BMI 26.9 kg/m2 vs. 28.5 kg/m2 (p = 0.13), discharge from hospital 5.4 days vs. 3.9 days (p = 0.038). There were no complications in either group.ConclusionsThe LESS AE is feasible in selected cases, especially small left-sided tumours in thin patients with no history of previous abdominal operations, but requires an additional port in half of the cases.

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Section: Discussionmentioning

confidence: 99%

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Hora¹,

Ürge²,

Stránský³

et al. 2014

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…Limited working space is one of the disadvantages of the retroperitoneal approach. Bigger-sized masses may cause more difficulties during operation [18]. Besides large adrenal masses, other difficulties such as presence of comorbidities, pheochromocytoma, higher age, and BMI lead to the preference of transperitoneal access, which provides limited operative and postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

Changing Surgical Approaches for Laparoscopic Adrenalectomy: Single-Surgeon Data of a 6-Year Experience

Arslan¹,

Akın²,

Ateş³

et al. 2013

Urol Int

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Aim: To evaluate outcomes of laparoscopic adrenalectomy (LA) and laparoendoscopic single-site surgery (LESS) for adrenal masses in the light of changing laparoscopic surgical techniques. Materials and Methods: Seventy-three patients were analyzed retrospectively. There were 2 groups; group 1 included patients who had conventional transperitoneal LA and transperitoneal LESS, and group 2 included patients who had lateral retroperitoneal LA, retroperitoneal LA in prone position, and retroperitoneal LESS. Demographic data, urine 3-methoxy-4-hydroxymandelic acid, normetanephrine, epinephrine, serum cortisol, aldosterone, adrenocorticotropic hormone, American Society of Anesthesiologists score, side and size of mass, conversion to open surgery, complications, estimated blood loss, operation time, pathological results were recorded and analyzed. Results: There was no difference in demographic data and serum parameters between both groups. Tumor size, estimated blood loss, operation time, transfusion rate and hospital stay were less for group 2 (p < 0.05, p = 0.0001). However, the complication rate was similar in both groups; in retroperitoneal prone position, the complication rate was less than for other surgical approaches, but statistically significant results could not be assessed. Conclusions: Even if the diameter of adrenal mass is larger than 6 cm, LA may be considered as the gold standard. The retroperitoneal approach especially in prone position may be a promising treatment method in the near future for adrenalectomy in selected patients.

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Laparoendoscopic Single-Site Retroperitoneoscopic Adrenalectomy for Pheochromocytoma: Case Selection, Surgical Technique, and Short-Term Outcome

Chen

Luo

et al. 2014

Journal of Endourology

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Retroperitoneal Laparoendoscopic Single-Site Adrenalectomy: Our Initial Technical Experience

Abstract: Retroperitoneal LESS adrenalectomy is feasible; although initial technical adjustments are inevitable, some useful techniques are effective in simplifying the procedure.

Cited by 7 publications

References 15 publications

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Changing Surgical Approaches for Laparoscopic Adrenalectomy: Single-Surgeon Data of a 6-Year Experience

Laparoendoscopic Single-Site Retroperitoneoscopic Adrenalectomy for Pheochromocytoma: Case Selection, Surgical Technique, and Short-Term Outcome

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