Gigantic Right-sided Pheochromocytoma Treated with Laparoscopic Bilateral Adrenalectomy

Cristina R Harnsberger, MD, Joshua Langert, MD, Ryan C Broderick, Hans F Fuchs, MD, Moneer E Almadani, MD, Christopher DuCoin, MD, Bryan J Sandler, MD, Garth R Jacobsen, MD, Michael Bouvet, MD, Santiago Horgan, MD. University of California, San Diego, Department of Surgery

Laparoscopic bilateral adrenalectomy can be a technically challenging case, particularly on the right side given the proximity to the inferior vena cava. We present a case of a 46 year-old female with bilateral adrenal masses, with the right-sided mass measuring greater than 5cm. Subsequent work-up was consistent with bilateral pheochromocytomas. The technique for laparoscopic bilateral adrenalectomy is presented including patient preparation, positioning, port placement, and surgical steps. The video demonstrates dissection of the right-sided tumor from the inferior vena cava and division of two right adrenal veins. In conclusion, laparoscopic bilateral adrenalectomy can be performed safely even in the setting of a large right-sided tumor causing inferior vena cava compression.

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