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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
"tubular drain in the end stage of the surgery"
symptom
adrenal incidentaloma
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