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Single-access retroperitoneal adrenalectomy.
[adrenal incidentaloma]
To
report
the
first
case
in
our
country
of
a
single
access--adrenalectomy
with
lateral
retroperitoneal
approach
by
using
SILS
port
and
to
evaluate
the
feasibility
and
safety
of
this
new
technique
.
A
50
-
year
-old
man
presented
with
38
mm
right
adrenal
incidentaloma
,
functionally
nonactive
and
without
radiologic
characteristics
suggestive
of
a
malignant
lesion
,
discovered
on
abdominal
computed
tomography
for
nephrolithiasis
.
The
single
access
adrenalectomy
was
attempted
with
multichannel
SILS
port
(
Covidien
)
,
inserted
through
a
3
cm
transverse
incision
at
the
tip
of
rib
XII
on
the
right
side
.
The
single
access
retroperitoneal
adrenalectomy
(
SARA
)
was
successfully
completed
without
any
intraoperative
complications
.
An
additional
lateral
5
-
mm
port
was
needed
for
retraction
of
the
kidney
and
for
tubular
drain
in
the
end
stage
of
the
surgery
.
The
operating
time
was
120
minutes
with
40
mL
of
blood
loss
.
Postoperative
recovery
was
uneventful
.
The
patient
was
discharged
from
the
hospital
on
the
second
postoperative
day
.
Pathologic
examination
confirmed
cortical
adenoma
of
the
adrenal
grand
.
No
morbidity
within
one
month
of
follow-up
,
and
excellent
cosmetic
results
.
This
is
the
first
case
of
a
single
access
retroperitoneal
adrenalectomy
(
SARA
)
by
using
SILS
port
was
performed
in
our
country
.
Based
on
our
primary
experience
,
we
believe
that
SARA
is
a
safe
and
feasible
procedure
for
selected
patients
with
adrenal
tumors
and
when
performed
by
a
surgeon
experienced
in
laparoscopic
and
adrenal
surgery
.
Although
initial
technical
adjustments
are
inevitable
,
simplifying
the
procedure
.
However
,
more
surgical
experience
using
this
technique
is
required
to
confirm
our
initial
impressions
.
Diseases
Validation
Diseases presenting
"first case"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
canavan disease
carcinoma of the gallbladder
child syndrome
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
fabry disease
familial mediterranean fever
focal myositis
gm1 gangliosidosis
harlequin ichthyosis
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
systemic capillary leak syndrome
thoracic outlet syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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