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- W2162431497 abstract "No AccessJournal of UrologyAdult Urology1 Feb 2011Laparo-Endoscopic Single Site Anatomical Retroperitoneoscopic Adrenalectomy Using Conventional Instruments: Initial Experience and Short-Term Outcome Xu Zhang, Tao-ping Shi, Hong-zhao Li, Xin Ma, and Bao-jun Wang Xu ZhangXu Zhang Equal study contribution. More articles by this author , Tao-ping ShiTao-ping Shi Equal study contribution. More articles by this author , Hong-zhao LiHong-zhao Li More articles by this author , Xin MaXin Ma More articles by this author , and Bao-jun WangBao-jun Wang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.084AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge we present the initial experience with and the short-term outcome of laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy using conventional instruments. Materials and Methods: Between June 2009 and April 2010, 25 patients underwent laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy. A TriPort™ Access System was inserted through a 2.5 to 3.0 cm transverse skin incision below the tip of the 12th rib. Adrenalectomy was done using a 5 mm 30-degree laparoscopic camera and 2 conventional laparoscopic instruments. After Gerota's fascia was incised we explored the first dissection plane between the perirenal fat and the anterior renal fascia at the superomedial side of the kidney. The adrenal gland was identified at the initial stage of the operation. Results: Laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy was successfully accomplished in 23 patients. An additional 5 mm port was required in 1 of the 2 unsuccessful cases and in the other it was necessary to convert to standard anatomical retroperitoneoscopic adrenalectomy. Median incision length was 3.0 cm, median operative time was 55 minutes and median estimated blood loss was 15 ml. No major intraoperative complications occurred. In the initial 10 cases median operative time was significantly longer (62 vs 50 minutes) and median blood loss was significantly higher (75 vs 10, each p <0.001) than in the subsequent 15. In 3 cases pheochromocytoma was successfully excised without undesirable hemodynamic oscillation. Postoperative complications developed in 2 patients, including angina and contralateral atelectasis in 1 each. Conclusions: In properly selected patients laparo-endoscopic single site anatomical retroperitoneoscopic adrenalectomy with conventional instruments is feasible, safe and effective, causes minimal morbidity and results in excellent cosmesis. References 1 : Single-puncture laparoscopic gastrostomy in children. Pediatr Surg Int1998; 14: 43. Google Scholar 2 : Gynecologically indicated single-endoloop laparoscopic appendectomy. J Am Assoc Gynecol Laparosc1998; 5: 275. Google Scholar 3 : Transumbilical single-port surgery: evolution and current status. Eur Urol2008; 54: 1020. Google Scholar 4 : Laparoendoscopic single-site surgery in urology: where have we been and where are we heading?. Nat Clin Pract Urol2008; 5: 561. Google Scholar 5 : Retroperitoneal laparoendoscopic single-site surgery in urology: initial experience. J Endourol2009; 23: 1857. Google Scholar 6 : Single-port laparoscopic retroperitoneal surgery: initial operative experience and comparative outcomes. Urology2009; 73: 1279. Google Scholar 7 : Technique of anatomical retroperitoneoscopic adrenalectomy with report of 800 cases. J Urol2007; 177: 1254. Link, Google Scholar 8 : Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). Urology2008; 72: 260. Google Scholar 9 : Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int2008; 101: 83. Google Scholar 10 : Single port transumbilical (E-NOTES) donor nephrectomy. J Urol2008; 180: 637. Link, Google Scholar 11 : Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol2005; 19: 788. Google Scholar 12 : Laparo-endoscopic single-site left transperitoneal adrenalectomy. Eur Urol2010; 57: 911. Google Scholar 13 : Single port access adrenalectomy. J Endourol2008; 22: 1573. Google Scholar 14 : Laparoscopic adrenalectomy using needlescopic instruments for adrenal tumors less than 5cm in 112 cases. Eur Urol2008; 54: 640. Google Scholar 15 : Technique of laparoscopic-endoscopic single-site surgery radical nephrectomy. Eur Urol2009; 56: 644. Google Scholar 16 : Does adrenal mass size really affect safety and effectiveness of laparoscopic adrenalectomy?. Urology2002; 60: 801. Google Scholar 17 : Comparative assessment of laparoscopic single-site surgery instruments to conventional laparoscopic in laboratory setting. J Endourol2010; 24: 239. Google Scholar 18 : Retrospective comparison of retroperitoneoscopic versus open adrenalectomy for pheochromocytoma. J Urol2008; 179: 57. Link, Google Scholar 19 : Retroperitoneoscopic adrenalectomy without previous control of adrenal vein is feasible and safe for pheochromocytoma. Urology2007; 69: 849. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLaguna M (2017) Re: Robot-Assisted vs Open Adrenalectomy: Evaluation of Cost-Effectiveness and Peri-Operative OutcomeJournal of Urology, VOL. 197, NO. 6, (1438-1438), Online publication date: 1-Jun-2017.Laguna M (2017) Re: Impact of Novel Techniques on Minimally Invasive Adrenal Surgery: Trends and Outcomes from a Contemporary International Large Series in UrologyJournal of Urology, VOL. 197, NO. 4, (998-1000), Online publication date: 1-Apr-2017. Volume 185Issue 2February 2011Page: 401-406 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsadrenalectomylaparoscopysurgical instrumentsadrenal glandskidneyMetrics Author Information Xu Zhang Equal study contribution. More articles by this author Tao-ping Shi Equal study contribution. More articles by this author Hong-zhao Li More articles by this author Xin Ma More articles by this author Bao-jun Wang More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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- W2162431497 title "Laparo-Endoscopic Single Site Anatomical Retroperitoneoscopic Adrenalectomy Using Conventional Instruments: Initial Experience and Short-Term Outcome" @default.
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