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Bilateral posterior retroperitoneal robotic adrenalectomy for ACTH-independent Cushing syndrome.
[cushing syndrome]
Laparoscopic
posterior
retroperitoneal
(
PR
)
adrenalectomy
is
preferable
in
patients
with
bilateral
adrenal
masses
,
as
it
obviates
the
need
for
repositioning
.
Robotic
adrenalectomy
has
been
reported
to
improve
surgeon
ergonomics
and
facilitate
dissection
.
Although
robotic
bilateral
transabdominal
lateral
adrenalectomy
has
been
described
in
the
literature
,
to
our
knowledge
,
the
robotic
bilateral
PR
approach
has
not
been
reported
before
.
Herein
,
we
report
a
case
of
a
bilateral
macronodular
adrenal
hyperplasia
managed
with
robotic
bilateral
PR
adrenalectomy
.
A
60
-
year
-old
man
was
incidentally
found
to
have
bilateral
macronodular
adrenal
masses
on
a
computed
tomography
scan
performed
for
abdominal
pain
.
His
laboratory
workup
was
significant
for
adrenocorticotropic
hormone-independent
bilateral
macronodular
adrenal
hyperplasia
.
He
was
consented
for
bilateral
PR
robotic
adrenalectomy
.
The
procedure
was
performed
robotically
through
a
PR
approach
.
Three
robotic
arms
were
used
for
the
procedure
on
both
sides
using
5
-
mm
instruments
.
Bilateral
adrenalectomy
was
performed
with
a
skin
-
to
-
skin
operative
time
of
268
minutes
(
98
min
for
the
left
and
170
min
for
the
right
side
)
.
The
patient
was
discharged
on
postoperative
day
1
uneventfully
on
steroid
supplementation
.
The
final
pathology
revealed
bilateral
adrenal
cortical
hyperplasia
.
To
our
knowledge
,
this
is
the
first
report
of
bilateral
robotic
PR
adrenalectomy
.
This
technique
enables
the
resection
of
bilateral
tumors
without
the
need
to
reposition
and
may
also
provide
potential
advantages
over
laparoscopy
,
regarding
the
ease
of
dissection
and
surgeon
ergonomics
.
Diseases
Validation
Diseases presenting
"first report"
symptom
achondroplasia
alexander disease
aniridia
cadasil
canavan disease
child syndrome
cohen syndrome
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentinogenesis imperfecta
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
harlequin ichthyosis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
homocystinuria without methylmalonic aciduria
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
lamellar ichthyosis
liposarcoma
lymphangioleiomyomatosis
monosomy 21
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
pendred syndrome
pleomorphic liposarcoma
primary hyperoxaluria type 1
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
werner syndrome
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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