Yates Jennifer, Uberoi Jayant, Munver Ravi
Department of Urology, Hackensack University Medical Center, 360 Essex Street, Suite 403, Hackensack, NJ, 07601, USA.
Touro University College of Medicine, Vallejo, NY, USA.
J Robot Surg. 2010 Sep;4(3):149-54. doi: 10.1007/s11701-010-0203-1. Epub 2010 Jul 22.
Adrenal-sparing surgery has recently been reported in the literature on minimally-invasive surgery. Originally described as a conventional laparoscopic procedure, encouraging outcomes in terms of preservation of adrenal function have been reported. Since the introduction of robotic surgery, surgeons have utilized robotic assistance for adrenal surgery and have recently described adrenal-sparing surgery using this platform. Certain patients that present with adrenal masses may benefit from minimally-invasive partial adrenalectomy, including those with a solitary adrenal gland, bilateral adrenal masses, and hereditary disease predisposing them to multiple adrenal masses. Patients without these conditions may also benefit from adrenal-sparing surgery in order to preserve normal adrenal function. We present the case of a patient with a 1.5-cm adrenal mass who elected to undergo adrenal-sparing surgery. The technique of transperitoneal laparoscopic partial adrenalectomy utilizing the da Vinci™ Surgical System is described. We also review the literature on minimally-invasive partial adrenalectomy in which robotic-assistance was utilized. In conclusion, while robot-assisted laparoscopic partial adrenalectomy remains in its infancy, it can be performed safely and with satisfactory surgical and functional outcomes.
肾上腺保留手术最近在微创外科文献中有所报道。最初被描述为一种传统的腹腔镜手术,在肾上腺功能保留方面已有令人鼓舞的结果报道。自机器人手术引入以来,外科医生已将机器人辅助用于肾上腺手术,并且最近描述了使用该平台的肾上腺保留手术。某些患有肾上腺肿块的患者可能受益于微创部分肾上腺切除术,包括那些只有一个肾上腺、双侧肾上腺肿块以及因遗传疾病易患多个肾上腺肿块的患者。没有这些情况的患者也可能从肾上腺保留手术中受益,以保留正常的肾上腺功能。我们介绍了一例患有1.5厘米肾上腺肿块且选择接受肾上腺保留手术的患者病例。描述了使用达芬奇™手术系统进行经腹腹腔镜部分肾上腺切除术的技术。我们还回顾了利用机器人辅助的微创部分肾上腺切除术的文献。总之,虽然机器人辅助腹腔镜部分肾上腺切除术仍处于起步阶段,但它可以安全地进行,并且手术和功能结果令人满意。