Department of Surgery, Tomishiro Central Hospital, 25 Ueta, Tomishiro, Okinawa, 901-0243, Japan.
Surg Today. 2011 Sep;41(9):1306-9. doi: 10.1007/s00595-010-4430-x. Epub 2011 Aug 26.
We herein report the first case of a single-incision laparoscopic access (SILA) adrenalectomy in Japan. A 74-year-old woman who was a hepatitis B virus carrier was referred to our hospital because of an abnormal screening result during a routine health checkup. Abdominal computed tomography and an endocrinologic workup revealed a 2-cm left adrenal tumor with primary aldosteronism. We prioritized the safety of the SILA adrenalectomy by choosing a left lower abdominal approach. A SILS port was inserted through a 2.5-cm incision. An ultrasonic coagulator was the main tool used during the surgical procedure. The duration of the surgery was 105 min and the blood loss was 1 ml. This result was comparable to that of a conventional laparoscopic adrenalectomy. Based on our experience, an SILA adrenalectomy is thus considered to be feasible and safe, with better cosmetic results and a greater overall patient satisfaction than that of a conventional laparoscopic adrenalectomy. However, further studies will be necessary before the universal adoption of this new technique can be considered.
我们在此报告日本首例经单孔腹腔镜（SILA）肾上腺切除术的病例。一位 74 岁的乙型肝炎病毒携带者，因常规健康检查时发现异常筛查结果而被转至我院。腹部计算机断层扫描和内分泌检查显示，左侧肾上腺有一个 2 厘米大的肿瘤，伴原发性醛固酮增多症。我们选择左下腹入路，优先考虑 SILA 肾上腺切除术的安全性。SILS 端口通过 2.5 厘米的切口插入。超声凝固器是手术过程中的主要工具。手术时间为 105 分钟，失血量为 1 毫升。该结果与传统腹腔镜肾上腺切除术相当。根据我们的经验，因此认为 SILA 肾上腺切除术是可行且安全的，与传统腹腔镜肾上腺切除术相比，具有更好的美容效果和更高的总体患者满意度。然而，在考虑普遍采用这项新技术之前，还需要进一步的研究。
