V04-02 ROBOT ASSISTED RIGHT PARTIAL ADRENALECTOMY

Abstract

You have accessJournal of UrologyAdrenal & Renal Oncology I (Nephron Sparing Surgery) (V04)1 Sep 2021V04-02 ROBOT ASSISTED RIGHT PARTIAL ADRENALECTOMY Joshua Cabral, Bryan Cortez, Onaje Artist, Anish Jain, and Adam Metwalli Joshua CabralJoshua Cabral More articles by this author , Bryan CortezBryan Cortez More articles by this author , Onaje ArtistOnaje Artist More articles by this author , Anish JainAnish Jain More articles by this author , and Adam MetwalliAdam Metwalli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002000.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pheochromocytomas are rare, functional catecholamine producing neuroendocrine tumors that can be adrenal or extra adrenal in origin. Their estimated incidence is 0.1% in the general population. Adrenalectomy is the gold standard treatment of pheochromocytoma, and since the 1990’s, laparoscopic and robotic techniques have emerged and replaced open approaches for managing small, benign masses. Currently, laparoscopic adrenalectomy remains controversial for large (size greater than 8-10 cm) tumors with more evidence needed to assess for viability and safety. Our study demonstrates the successful removal of a 14.6x15.7x10.6 cm using a robot assisted laparoscopic technique. METHODS: Our patient was a 57-year-old Hispanic male who presented with headaches, dizziness, and 30lb weight loss in the setting of a large right upper quadrant mass on abdominal ultrasound. Abdominal CT showed a 14.6x15.7x10.6 cm heterogenous mass within the right upper quadrant, with cystic and solid components, causing displacement of adjacent structures. Hormonal workup showed markedly elevated catecholamines consistent with a pheochromocytoma. The patient was consented for and underwent a Robotic Assisted Laparoscopic Right Partial Adrenalectomy. He underwent alpha blockade and catecholamine synthesis inhibition for the two weeks prior to surgery. RESULTS: After the mass was removed the inferior vena cava resumed its orthotopic position intraoperatively, was no longer effaced, and appeared relatively full and normal in caliber. Post-operatively the patient was admitted to the SICU, and required 48 hours of pressor support with pharmacological agents, crystalloid and colloid. His postoperative course was otherwise unremarkable, and he was discharged on postoperative day (POD) 5. He was seen in the clinic on POD 27 with no complaints and with resolution of his symptoms and normalization of his catecholamines. CONCLUSIONS: Robot Assisted Partial Adrenalectomy can successfully be performed for large (>10 cm) pheochromocytomas. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e291-e291 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Cabral More articles by this author Bryan Cortez More articles by this author Onaje Artist More articles by this author Anish Jain More articles by this author Adam Metwalli More articles by this author Expand All Advertisement Loading ...