Two Cases of Pheochromocytoma Treated with Hand-assisted Laparoscopic Surgery

Abstract

Case 1 : A 35-year-old female patient underwent laparoscopic bilateral adrenalectomy for bilateral adrenal pheochromocytomas. As the right pheochromocytoma was too large (13.5 cm) to be removed only by a laparoscopic procedure, hand-assisted laparoscopic surgery (HALS) was used after adequate exposure of the tumor.

Case 2 : An 82-year-old female underwent laparoscopic left adrenalectomy for a pheochromocytoma 10 cm in size. The posterior and superior surfaces of the tumor were dissected using a laparoscopic procedure, which was then converted to HALS.

Both cases required an extended skin incision for the hand port to facilitate removal of the tumor. HALS is a tactile technique that enables protective tumor traction and surgical field development. The laparoscope enables observation in the retroperitoneal region of the upper abdomen, where maintaining a surgical field of view is anatomically difficult. HALS for large pheochromocytomas is a safe, minimally invasive, and curative management procedure.