Laparoscopic surgery has become a standard method for treatment of adrenal disease. Between June 1994 and June 2015, we performed 604 laparoscopic adrenalectomies including primary aldosteronism.
Recently there has been growing advocacy to perform partial adrenalectomy for aldosterone producing adenomas(APA), when proved to be causing hyperaldosteronism by Segmental Adrenal Tributary Sampling(S-ATS).
We describe our technique with laparoscopic total and partial adrenalectomy using the transperitoneal approach for APA.
Laparoscopic total and partial adrenalectomy was complete in all cases without conversion to open surgery and blood transfusion, and most complications in our cohort were minor and there was no mortality. These results show the procedure to be safe and effective.
Partial adrenalectomy compared favorably to total adrenalectomy for some perioperative outcomes. Operative duration was 123 and 96 minutes in total and partial adrenalectomy respectively(P<0.01). Hypertension resolution rate was 39.3% and 65.9% in the total and partial cases respectively(P<0.05).
Laparoendoscopic single-site surgery(LESS) was introduced to our hospital in November 2011. LESS is a good indication of adrenalectomy because the adrenal tumor is often small. In LESS, all of the instrument to used perform the procedure must be placed through a single incision, often concealed within the umbilicus. It has evolved to improve upon cosmesis associated with standard laparoscopic surgery. We show our experience with LESS.
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