Transperitoneal Laparoscopic Adrenalectomy: Outline of the Preoperative Management, Surgical Approach, and Outcome

Zacharias, Mario; Haese, Alexander; Jurczok, A.; Stolzenburg, Jens‐Uwe; Fornara, Paolo

doi:10.1016/j.eururo.2006.01.014

Cited by 97 publications

(80 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several approaches have been developed to reach and remove the adrenal glands [6][7][8]; of these, the LTP approach is the most popular technique for laparoscopic adrenalectomy [9]. However, as neither a standard approach to the adrenal region nor reliable criteria to select the most suitable route have been defined, a consensus has not been reached regarding the appropriate port placements for the previously reported LTP approach [10][11][12][13]. Because a model has shown the optical axis-to-target view (OATV) angle [17], alteration in angle of vision or the angle between the optical axis of the endoscope and the instruments' plane can influence surgical performance and altering the port configuration may possibly affect the outcomes [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Many surgeons choose a triangle port configuration in which the camera port is placed at or near the umbilicus with working ports around the adrenal region [10][11][12]. In such cases, if a patient is placed in the supine position, the abdominal organs must be widely mobilised to reach the area of the adrenal gland.…”

Section: Discussionmentioning

confidence: 99%

“…However, no standard lateral transperitoneal approach to the adrenal region has ever been defined. The approach varies among reports [10][11][12][13], as port placement is determined by the surgeon's preference based on individual experience. We first applied a triangular port configuration involving camera access just lateral to the edge of the rectus sheath at the level of the umbilicus; however, the visibility of the videoscope is less desirable, as it might be impaired by a sagging bowel.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy

Zhou

Fan

et al. 2015

Indian J Surg

View full text Add to dashboard Cite

The purpose of this study was to evaluate the safety and efficacy of the modified lateral transperitoneal (MLTP) approach in comparison with the traditional lateral transperitoneal (LTP) and lateral retroperitoneal (LRP) approach. From January 2008 to December 2012, 287 patients underwent laparoscopic adrenalectomy, and the MLTP, LTP and LRP approaches were used in 93, 96 and 98 patients. The patients' demographics and surgical outcomes from the three approaches were reviewed and compared. There were no significant differences in the general demographic or postoperative recovery variables among the three groups. However, the average volume of blood lost was lower for the MLTP group than for the other two groups. Additionally, the average operative time was significantly shorter in the MLTP group than in the LTP group and slightly shorter than in the LRP group, but the differences were not statistically significant. This study shows that the MLTP approach is a safe and effective procedure which is associated with shorter operative time and lower volumes of blood loss.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy

Zhou

Fan

et al. 2015

Indian J Surg

View full text Add to dashboard Cite

show abstract

“…[24] Intraoperatively, histopathologically benign adrenal masses are more frequently encountered. In a series of 52 patients adrenalectomized by Zacharias et al [25] 34 patients with benign pathology had been reported. These outcomes were supported by Suresh et al [26] In our series, 18 of 24 cases had benign pathologies.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic transperitoneal adrenalectomy: Our initial results

Özgör

Binbay

Akbulut

et al. 2014

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: To present the first 24 laparoscopic adrenalectomies performed in our clinic because of an adrenal mass. Material and methods:The medical files of 24 patients who underwent laparoscopic adrenalectomy between December 2008 and March 2013 at Haseki Teaching and Research Hospital were analyzed retrospectively. The demographic characteristics of the patients were recorded. Lateral transperitoneal laparoscopic adrenalectomy was performed in all patients. The operation time was defined as the interval between the first incision of the skin and closure of the skin. Intraoperative complications, estimated blood loss and hospital stays of the patients were evaluated. Final pathologies were recorded. Results:The mean age of the patients was 44.2±8.58 years (range: 29-66 years). Nine patients were female and 15 were male. A total of 24 masses were identified in the right (n=11), and left (n=13) adrenal glands masses were identified., Eighteen patients (75%) had no symptoms, and the masses were identified incidentally. The mean operation time was 144±46.1 minutes (range: 90-320 minutes), and the mean blood loss was 74±12.3 mL (range: 50-130 mL). None of the patients required a blood transfusion. In one patient, liver injury was identified intraoperatively due to traction. The mean duration of hospitalization was 2.9±1.1 days (range: 2-5 days). Adrenocortical adenoma and pheochromocytoma were the most common pathologies. Conclusion:Laparoscopic adrenalectomy is a safe and effective method for the treatment of adrenal masses with low complication rates.

show abstract

“…All day surgery cholecystectomies cases were elective and surgery was scheduled in the early morning to enable a safe observation period. For left adrenalectomies [16] we decided to adopt the technical principles described by Zacharias [17]. Briefly, we start by incising Toldt's line from the splenic flexure to the sigmoid junction to medially reflect the left colon.…”

Section: Operative Techniquesmentioning

confidence: 99%

Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience

Martı́¹,

Vidal²,

Valentini³

et al. 2015

IJCM

View full text Add to dashboard Cite

Background: Single incision laparoscopic surgery (SILS) has still not replaced conventional laparoscopic surgery in many centers because of its special instruments requirements and training needs. In our Institution we introduced SILS procedures in a procedural stepwise manner, with progression to more difficult procedures only allowed if complete proficiency in low-complexity ones is achieved. Methods: We studied the evolution of performed SILS procedures in our Institution from the beginning of the program (mainly appendectomies, cholecystectomies, left adrenalectomies) and the results from these techniques. Results: Among 328 SILS procedures there were 148 appendectomies (24 by suprapubic access), 141 cholecystectomies, 32 left adrenalectomies, 6 diagnostic laparoscopies and 1 resection of Meckel's diverticulum. The majority of appendectomies accounted for non-perforated appendicitis cases and there were no significant differences between transumbilical and suprapubic access groups. In cholecystectomies the majority of patients were elective cases and oral intake could be resumed within the 6 postoperative hours. In left adrenalectomies no conversion to open surgery was required and there were no intraoperative or postoperative complications. Conclusions: Procedural stepwise approach in SILS is a valid, feasible and safe option that can be applied at any institution starting a SILS program.

show abstract

Transperitoneal Laparoscopic Adrenalectomy: Outline of the Preoperative Management, Surgical Approach, and Outcome

Cited by 97 publications

References 20 publications

Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy

Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy

Laparoscopic transperitoneal adrenalectomy: Our initial results

Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience

Contact Info

Product

Resources

About