Deus Javier, Millera Alfonso, Andrés Alejandro, Prats Enrique, Gil Ismael, Suarez Manuel, Salcini José L, Lahoz Manuel
From the Department of Surgery, University Hospital, Zaragoza, Spain (JD, AM, IG, MS); Department of Nuclear Medicine, University Hospital, Zaragoza, Spain (AA, EP); Department of Podiatry, University of Sevilla, Spain (JLS); and Department of Human Anatomy and Histology, University of Zaragoza, Spain (ML).
Medicine (Baltimore). 2015 Sep;94(39):e1397. doi: 10.1097/MD.0000000000001397.
The laparoscopic adrenalectomy is considered as the procedure of choice for the treatment of adrenal hyperplasia and tumor lesions. However, some special situations may limit the use of this method due to the difficulty to locate the gland and perform the lesion excision. We analyze 2 patients of a left adrenal tumor, explaining how they have overcome the difficulties in both situations. The first case was a patient with a history of intra-abdominal surgery and the other patient suffered from severe obesity. We performed with the use of the gamma probe, and the 2 cases, was of great help to access and glandular localization. The help of gamma probe test was achieved in the surgical bed, that removal was complete. The use of the portable gamma probe facilitated the access to the left adrenal gland as well as conducting the glandular excision without delay, despite the difficulties due to the intra abdominal surgery caused by the previous surgery, and in the case of severe obesity.
腹腔镜肾上腺切除术被认为是治疗肾上腺增生和肿瘤病变的首选手术方法。然而，由于肾上腺定位困难和病变切除难度大，一些特殊情况可能会限制该方法的应用。我们分析了2例左侧肾上腺肿瘤患者，阐述了如何在这两种情况下克服困难。第一例患者有腹部手术史，另一例患者患有严重肥胖症。我们使用γ探针进行手术，这对这2例患者的肾上腺定位和暴露起到了很大的帮助。在手术床上借助γ探针检测，成功完整切除肾上腺。便携式γ探针的使用有助于暴露左侧肾上腺，并且能够在存在既往腹部手术造成的困难以及严重肥胖的情况下，及时进行肾上腺切除。
