Retroperitoneoscopic Partial Adrenalectomy Using an Endoscopic Stapling Device in Patients with Adrenal Tumor

Abstract

We performed 15 retroperitoneoscopic partial adrenalectomies using an endoscopic stapling device to divide the normal adrenal tissue and adenoma. The mean operating time and mean blood loss were 162 (129–210) min and 12 (5–67) ml, respectively. In 1 patient (6.7%), a pneumothorax occurred at the end of the procedure due to injury of the medial crus of the diaphragm. However, the procedure was not subsequently converted to open surgery. These facts suggest that posterior retroperitoneoscopic partial adrenalectomy is a valuable addition to adrenal gland surgery.

Peyronie’s Disease: Prevalence and Association with Cigarette Smoking

“…Furthermore, this study shows that the evaluation of risk factors in clinical studies can be strongly influenced by bias, in that it selects only the patients with more severe symptoms who more frequently seek out a specialist. This methodological observation must be given the appropriate weight when clinical studies draw correlations regarding etiological and risk factors for PD [7, 8, 9, 10]. …”

Influence of Carbon Dioxide on Respiratory Function during Posterior Retroperitoneoscopic Adrenalectomy in Prone Position

“…During endoscopic surgery, retroperitoneal pressure was maintained at 12–16 mm Hg using a CO 2 insufflator. All procedures were completed using 3 trocars [5]. …”

“…During conventional laparoscopic adrenalectomy, intraperitoneal CO 2 insufflation is followed by a marked increase in PaCO 2 and PetCO 2 with opening of the retroperitoneum [3]. Recently, posterior retroperitoneoscopic adrenalectomy (PRA) in the prone position has become a new minimally invasive procedure [4, 5]. However, there are no studies on CO 2 absorption and gas exchange after retroperitoneal subphrenic inflation of CO 2 in the prone position.…”

Nebennierenresektion zum Erhalt der adrenokortikalen Funktion

“…Auch finden sich bezüglich der [25,33]. Im Vergleich zum Conn-Syndrom sind die Erfahrungen beim Cushing-Syndrom limitiert [59,73]. In der bislang größten Studie haben wir bei 20 von 76 Patienten mit Cushing-Adenomen eine Nebennierenresektion durchgeführt [71].…”

“…Nebennierenparenchym kann durch monopolare und bipolare Diathermie sowie mittels Ultraschallschere und Klammerschneidegeräte als auch nach Klipp-Applikation durchtrennt werden [11,29,30,59,73]. Wir bevorzugen moderne Dissektionsinstrumente wie Ultraschall-oder bipolare Schere.…”