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LEFT ADRENALECTOMY AND RETROPERITONEAL LYMPHADENECTOMY BY HYBRID MINIMALLY INVASIVE TECHNIQUE: A CASE REPORT

Diego L Lima, MD1, Gustavo L Carvalho, MD, phD2, Raimundo H Furtado, MD2, Gustavo H Belarmino de Goes, Medical Student2, Lucyeli L Amorim, Medical Student2. 1State Servers Hospital, 2University of Pernambuco

Case Report: A 26-year-old male patient who was diagnosed with high blood pressure at 18 years-old and presented tetraparesis and intense asthenia for six months. Blood tests showed hypokalemia, hypernatremia, and suppressed renin activity. Ultrasound of the urinary tract was normal.  CT scan of the abdomen showed a hypodense nodule with regular margins, measuring 1.4 x 1.0 cm with a density of 18 HU in the non-contrast phase and heterogeneous uptake after the injection of the contrast in the left adrenal gland. Thus, the diagnosis of hyperaldosteronism secondary to the left adrenal nodule was confirmed, and surgical resection was indicated. The procedure was performed with the patient in the right lateral decubitus. Two 3-mm and one 5-mm trocars were used on the left flank, as well as the 10-mm portal for the camera in the lower right quadrant under direct vision. The pneumoperitoneum was created by the Hasson open technique in the transumbilical incision. The procedure consisted of the dissection, isolation and electrocautery of the left renal capsule and the left adrenal region with ultrasonic device, as well as the periadrenal vessels, adjacent lymph nodes and periadrenal and adrenal fat tissue. The surgery was uneventful and the patient had no further complications, being discharged the next day. Histopathologic result showed a completely excised adrenocortical adenoma.

Conclusions: The hybrid minimally invasive approach proved to be safe and effective for this procedure, and the known advantages of minilaparoscopy such as less trauma, better visualization, better dexterity, better aesthetics, and reduced hospital stay were observed.

 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86709

Program Number: P152

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

36

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