Sasaki Akira, Baba Shigeaki, Obuchi Toru, Umemura Akira, Mizuno Masaru, Wakabayashi Go
Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 0200-8505, Japan.
J Med Case Rep. 2012 Jul 18;6:208. doi: 10.1186/1752-1947-6-208.
Single-port laparoscopic adrenalectomy is one of the most interesting surgical advances. Here, we evaluate the safety and feasibility of single-port laparoscopic adrenalectomy as treatment for a right-sided aldosterone-producing adenoma.
A 39-year-old Japanese woman presented with hypertension and hypokalemia. Abdominal computed tomography and an endocrinological workup revealed a 19mm right adrenal tumor with primary aldosteronism. Our patient was informed of the details of the surgical procedure and our efforts to reduce the number of incisions needed - ideally, to a single incision - when removing her adrenal gland. A single-port laparoscopic adrenalectomy was attempted. A multichannel port was inserted through a 2.5cm umbilical incision. A 5mm flexible laparoscope, articulating laparoscopic dissector and tissue sealing device were the primary tools used in the operation. The right liver lobe was evaluated using a percutaneous instrument, providing good visualization of the operative field surrounding her right adrenal gland. The single-port laparoscopic adrenalectomy was successfully completed without any intraoperative complications. The operating time was 76 minutes, and her blood loss was 5mL. Oral intake was resumed on the first postoperative day, and the length of her hospital stay was three days. Her postoperative course was uneventful with no morbidity within one month of follow-up, and our patient had excellent cosmetic results.
Single-port laparoscopic adrenalectomy is a safe and feasible procedure for patients with a right-sided adrenal tumor when performed by a surgeon experienced in laparoscopic and adrenal surgery. However, more surgical experience using this technique is required to confirm our initial impressions.
单孔腹腔镜肾上腺切除术是最引人关注的外科进展之一。在此，我们评估单孔腹腔镜肾上腺切除术治疗右侧醛固酮瘤的安全性和可行性。
一名39岁的日本女性，表现为高血压和低钾血症。腹部计算机断层扫描及内分泌检查发现右侧肾上腺有一个19mm的肿瘤，伴有原发性醛固酮增多症。我们向患者详细介绍了手术过程，以及在切除其肾上腺时为减少所需切口数量（理想情况下为单个切口）所做的努力。尝试进行单孔腹腔镜肾上腺切除术。通过一个2.5cm的脐部切口插入一个多通道端口。操作中主要使用了5mm的可弯曲腹腔镜、关节式腹腔镜解剖器和组织封闭装置。使用经皮器械对右肝叶进行评估，能很好地观察其右肾上腺周围的手术视野。单孔腹腔镜肾上腺切除术成功完成，术中无任何并发症。手术时间为76分钟，出血量为5mL。术后第一天恢复经口进食，住院时间为三天。术后过程顺利，随访一个月内无任何发病情况，患者的美容效果极佳。
对于有右侧肾上腺肿瘤的患者，由有腹腔镜和肾上腺手术经验的外科医生进行单孔腹腔镜肾上腺切除术是一种安全可行的手术方法。然而，需要更多使用该技术的手术经验来证实我们最初的印象。
