V11-10 ROBOT ASSISTED PARTIAL ADRENALECTOMY FOR FUNCTIONING ADRENAL MASSES

Abstract

You have accessJournal of UrologyAdrenal/Single Port Surgery/LESS/NOTES1 Apr 2016V11-10 ROBOT ASSISTED PARTIAL ADRENALECTOMY FOR FUNCTIONING ADRENAL MASSES Giuseppe Simone, Gabriele Tuderti, Antonio Stigliano, Rocco Papalia, Mariaconsiglia Ferriero, Riccardo Mastroianni, Francesco Minisola, Leonardo Misuraca, Salvatore Guaglianone, and Michele Gallucci Giuseppe SimoneGiuseppe Simone More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Antonio StiglianoAntonio Stigliano More articles by this author , Rocco PapaliaRocco Papalia More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Francesco MinisolaFrancesco Minisola More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , and Michele GallucciMichele Gallucci More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1827AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present two cases of robotic partial adrenalectomy performed in a 54yr-old female with a 3 cm left adrenal mass and increased levels of urinary metanephrines and in a 40 yr-old female with a 2 cm left adrenal mass and increased levels of serum aldosterone, respectively. METHODS In the first case, with the patient in a flank position, a four trocar access was performed; Gerota' s fascia was incised at the level of the upper pole and the adrenal gland identified; the medial aspect of the gland was bluntly dissected and some minor vessels feeding the mass were selectively clip legated and divided; the mass was progressively mobilised starting from the medial aspect and an enucleation was performed in order to maximize the adrenal parenchyma spared; the specimen was macroscopically inspected to ensure the absence of any margin violation and it was placed into an endobag for extraction. The second case shows the same surgical access. Enucleation was performed as previously described, and a sliding clip suture was performed to approximate the margins of the adrenal gland; pathological evaluation showed the presence of an intact 1,5 mm capsule all around the adenoma, with a small rim of adrenal cortex parenchyma. RESULTS Intraoperative blood loss was negligible, postoperative course was uneventful in both cases and patients were discharged on second postoperative day. Both patients bacame normotensive immediately after surgery. Both the patients were referred to endocrinological consultation after discharge. Aldosterone and potassium levels for the first patient, as well as urinary metanephrines for the second patient were in the normal range. CONCLUSIONS Robotic partial adrenalectomy is a safe, feasible and minimally technique; robotic platform facilitates either tumor enucleation or parenchymal suture. An increasing adoption of adrenal sparing surgery is likely to be anticipated. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1006 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Giuseppe Simone More articles by this author Gabriele Tuderti More articles by this author Antonio Stigliano More articles by this author Rocco Papalia More articles by this author Mariaconsiglia Ferriero More articles by this author Riccardo Mastroianni More articles by this author Francesco Minisola More articles by this author Leonardo Misuraca More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...