Cougard P, Osmak L, Goudet P
Service de chirurgie générale et endocrinienne, hôpital général, 3, rue du Faubourg-Raines, 21000, Dijon, France.
Ann Chir. 2003 Jun;128(5):339-43. doi: 10.1016/s0003-3944(03)00109-3.
The transperitoneal laparoscopic approach for right adrenalectomy is performed in patients placed in a lateral decubitus position. Four ports are usually needed (2 or 3, 10 mm ports, 1 or 2, 5 mm ports), inserted in the right subcostal area. After liver retraction, the retroperitonéal space is opened close to the liver, exposing the right adrenal gland and the inferior vena cava. The periphrenic fat and the internal side of the gland are dissected close to the right side of the vena cava in order to expose the main adrenal vein. This vein is double clipped. At the inferior pole of the gland, the inferior adrenal artery is ligated with clips. Before removing and extracting the gland, the right side and the upper pole of the gland are dissected last.
经腹腔腹腔镜右肾上腺切除术在侧卧位患者身上进行。通常需要四个端口（2个或3个10毫米端口，1个或2个5毫米端口），插入右肋下区域。在牵拉肝脏后，靠近肝脏打开腹膜后间隙，暴露右肾上腺和下腔静脉。在腔静脉右侧靠近膈下脂肪和肾上腺内侧进行解剖，以暴露肾上腺主静脉。该静脉用双重钛夹夹闭。在肾上腺下极，用钛夹结扎肾上腺下动脉。在切除并取出肾上腺之前，最后解剖肾上腺右侧和上极。
