Laparoscopic Left Adrenalectomy: A New Approach

Abstract

Left adrenalectomy has been performed previously via anterior, posterior, loin or thoracoabdominal approaches. In the classical transabdominal approach the left adrenal gland is resected following either mobilization of the spleen with the tail of the pancreas or after entering the lesser sac, mobilizing the inferior border of the pancreas off the adrenal gland. This report describes laparoscopic left adrenalectomy, in a patient with Conn's syndrome, performed by a new approach via the root of the left transverse mesocolon.

Surgical treatment of pheochromocytomas

“…The latter require a balloon trocar, which is expanded in the retroperitoneal fat at the beginning of the procedure to create a space similar to that in endoscopic preperitoneal hernia repair [10]. Like many other authors [3,12,14,15,17,23,24], we prefer the laparoscopic transperitoneal techniques. After our first 28 laparoscopic adrenalectomies, which had been performed with the patient in the lithotomy position, we changed our technique to the transperitoneal approach with the patient in the lateral decubitus position as described by Gagner et al [6].…”

Laparoscopic urology development in Hong Kong

“…The initial reports were on varicelectomy and in paediatic urological topic in 1994 and rapidly various other areas were covered Table 1). 3–70 This was in parallel with the worldwide trend of development. There were a total of 68 presentations identified (abstracts and full papers included).…”

The millennium archives: Hong Kong contribution to World literature on video‐endosurgery in the second millennium

“…42,154 Many case studies bore testimony to the efficacy of an ingenuous modification, hailed by the authors as a better alternative to the existing technique. Examples are in abundance: one-suture 109 or sutureless repair of perforated peptic ulcer, 11 thoracoscopic vagotomy, 2,107 anterior approach to the adrenals, 29,33,34 two-port technique for laparoscopic cholecystectomy, 60 suprapubic ports for appendicectomy, 122 ligature intrathoracic anastomosis, 99 one-port Tenchkoff insertion technique, 130 thoracosopic suturing of bullae, 40 argon beam pleurectomy, 158 cervicoscopic parathyroid adenectomy 111,145,157 and laparoscopic vagotomy in conjunction with gastroenterostomy 72 or pyroloplasty. 68 While many of them have now become widely adopted, some have failed to stand the test of time and have since fallen into disfavour.…”

“…68 While many of them have now become widely adopted, some have failed to stand the test of time and have since fallen into disfavour. 29,33,34 Other series were truly first of their kinds in expanding the application of the minimally invasive approach to the management of vaginal ectopic ureter, 135,165 pulmonary tuberculosis, 78,168 persistent Mullerian duct syndrome, 103 sigmoid volvulus 91 and varicoceles in children. 32 Many novel technical tips and aids aimed at making the procedure user-friendly were described.…”