Videosurgery and Other Miniinvasive Techniques (Sep 2010)
Preliminary experience with transperitoneal single incision laparoscopic surgery adrenalectomy
Abstract
Introduction: The aim of contemporary medicine is not only a successful course of the operation, leading to improvementof the patient’s health status, but also its satisfactory cosmetic effect. Single incision laparoscopic surgery (SILS) is a newadvance wherein laparoscopy is carried out through a small incision hidden in the umbilicus. It therefore combines thesetwo major objectives allowing for a good clinical result after a practically scarless operation. Aim: To present the preliminary experience in using the SILS method for treatment of patients with adrenal glandtumours.Material and methods: In March 2010 we performed 7 SILS adrenalectomies in patients treated in our department.Preoperative examinations confirmed hormonal activity in 6 of them and in 1 patient increase in the size of thetumour (by 12 mm) was the indication for the operation. All procedures were performed using the lateraltransperitoneal approach where after creation of a small incision in the umbilicus the SILS port was placed. Theoperation was then conducted using a technique similar to standard multiport adrenalectomy. In 1 patient it wasnecessary to place 2 additional trocars in order to properly mobilize the spleen. Results: We did not observe any difference in the operative time versus multiport laparoscopy. No postoperativecomplications occurred. Conclusion: SILS adrenalectomy is a safe procedure but requires a lot of experience in laparoscopic adrenalectomy.If any problem occurs during the procedure it is always possible to place additional trocars and convert the operationto multiport laparoscopy. To date the only evidenced advantage of the new procedure is its better cosmetic result.
