2015 Volume 48 Issue 6 Pages 371-375
Although laparoscopic surgery is a well-established minimally invasive option, it still requires several incisions. With the aim of improving cosmesis and preventing port-site complications, surgical procedures, devices, and instruments have been developed. A new alternative to conventional laparoscopic surgery is single-port or single-incision laparoscopic surgery. Furthermore, embryonic natural orifice transluminal endoscopic surgery via the umbilicus is a recent technical innovation. We report here a case of adrenal myelolipoma successfully managed by transumbilical laparoendoscopic single-site (LESS) adrenalectomy in a patient under hemodialysis. A 75-year-old man receiving hemodialysis for 8 years was incidentally discovered to have a tumor, 7.2×6.7×8.9 cm in diameter, at the left adrenal gland. A 3.5 cm periumbilical longitudinal incision for Gelpoint was made and three trocars were inserted into the abdominal cavity. We performed transumbilical LESS adrenalectomy for left adrenal tumor using a flexible laparoscope and articulating instrument. The resected specimen was pathologically diagnosed as adrenal myelolipoma. There were no intraoperative and postoperative complications. The patient started oral intake and ambulation on the first postoperative day, and left the hospital five days after surgery. Transumbilical LESS adrenalectomy is safe and feasible for patients with hemodialysis.
