Laparoendoscopic single-site (LESS) retroperitoneal partial adrenalectomy using a custom-made single-access platform and standard laparoscopic instruments: technical considerations and surgical outcomes

Chen-Hsun Ho, Pin-Wen Liao, Victor C Lin, Fu-Shan Jaw, Shih-Chieh Jeff Chueh, Shiu-Dong Chung, Shih-Ping Liu, Yao-Chou Tsai, Hong-Jeng Yu

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: We previously reported our initial experience with laparoendoscopic single-site (LESS) retroperitoneal partial adrenalectomy using a custom-made single-port device and conventional straight laparoscopic instruments.

METHODS: Between December 2010 and February 2012, LESS retroperitoneal partial adrenalectomies were performed in 11 patients. Six patients had aldosterone-producing adenomas (APAs) and five patients had nonfunctioning tumors. A single-port access was created with an Alexis wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA) through an incision of 2-3 cm beneath the tip of the 12th rib. All procedures were performed with straight laparoscopic instruments.

RESULTS: All LESS procedures were successfully completed without conversion to traditional laparoscopic conversion. The tumors ranged from 1 cm to 4.7 cm (mean, 2.3 cm). The operative time was 71-257 minutes (mean, 121 minutes). Most patients (n = 8) had minimal blood loss; the other three patients had a blood loss of 150 mL, 100 mL, and 100 mL. The mean hospital stay was 3 days (range, 1-6 days). There were no perioperative or postoperative complications. Pathological examinations revealed negative surgical margins in all specimens. All patients with Conn's syndrome had an improvement in blood pressure and normalization of plasma renin activity and serum aldosterone levels; all patients were free of potassium supplementation.

CONCLUSION: Our results clearly demonstrate that LESS retroperitoneal partial adrenalectomy can be performed safely and effectively using a custom-made single-access platform and standard laparoscopic instruments.

Original languageEnglish
Pages (from-to)6-12
Number of pages7
JournalAsian Journal of Surgery
Volume38
Issue number1
DOIs
Publication statusPublished - Jan 2015
Externally publishedYes

Keywords

  • Adrenal Cortex Neoplasms
  • Adrenalectomy
  • Adrenocortical Adenoma
  • Aged
  • Female
  • Humans
  • Hyperaldosteronism
  • Laparoscopy
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Retroperitoneal Space
  • Surgical Instruments
  • Treatment Outcome
  • Journal Article

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