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Adrenalectomy

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Serdar Tezelman – One of the best experts on this subject based on the ideXlab platform.

  • Single-incision laparoscopic Adrenalectomy
    Surgical endoscopy, 2011
    Co-Authors: Fatih Tunca, Yasemin Giles Senyurek, Tarik Terzioglu, Yalın İşcan, Serdar Tezelman
    Abstract:

    Background The aim of this study was to compare outcome measures between conventional transabdominal laparoscopic Adrenalectomy and single-incision laparoscopic Adrenalectomy (SILA).

  • Single-incision laparoscopic left Adrenalectomy.
    Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2010
    Co-Authors: Fatih Tunca, Yasemin Giles Senyurek, Tarik Terzioglu, İsmail Cem Sormaz, Serdar Tezelman
    Abstract:

    BACKGROUND: Single-incision laparoscopic surgery (SILS) has gained an interest and popularity in the recent years. Although minimally invasive adrenal surgery replaced the open Adrenalectomy, SILS Adrenalectomy is a step forward technique that improves the cosmesis, decreases acsess related morbidity, and increases the postoperative recovery. We report our first experience with single-incision transperitoneal left Adrenalectomy in a patient with Conns’ syndrome. CASE: A 46-year-old female patient with a diagnosis of Conns’ syndrome underwent single-incision transperitoneal laparoscopic left Adrenalectomy. SILS port (Covidien, Norwalk, CT) was used through a 2-cm incision and additional one 5-mm trocar used through one of the holes of SILS port to solve the smoke problem. The operative time was ended in 50 minutes, and no peroperative compcomplication was encountered. The patient was discharged at the second postoperative day. CONCLUSION: SILS Adrenalectomy is a safe procedure for a benign adrenal lesion in experienced hands. Further studies are needed to evaluate the special benefits of this technique.

Fatih Tunca – One of the best experts on this subject based on the ideXlab platform.

  • Single-incision laparoscopic Adrenalectomy
    Surgical endoscopy, 2011
    Co-Authors: Fatih Tunca, Yasemin Giles Senyurek, Tarik Terzioglu, Yalın İşcan, Serdar Tezelman
    Abstract:

    Background The aim of this study was to compare outcome measures between conventional transabdominal laparoscopic Adrenalectomy and single-incision laparoscopic Adrenalectomy (SILA).

  • Single-incision laparoscopic left Adrenalectomy.
    Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2010
    Co-Authors: Fatih Tunca, Yasemin Giles Senyurek, Tarik Terzioglu, İsmail Cem Sormaz, Serdar Tezelman
    Abstract:

    BACKGROUND: Single-incision laparoscopic surgery (SILS) has gained an interest and popularity in the recent years. Although minimally invasive adrenal surgery replaced the open Adrenalectomy, SILS Adrenalectomy is a step forward technique that improves the cosmesis, decreases acsess related morbidity, and increases the postoperative recovery. We report our first experience with single-incision transperitoneal left Adrenalectomy in a patient with Conns’ syndrome. CASE: A 46-year-old female patient with a diagnosis of Conns’ syndrome underwent single-incision transperitoneal laparoscopic left Adrenalectomy. SILS port (Covidien, Norwalk, CT) was used through a 2-cm incision and additional one 5-mm trocar used through one of the holes of SILS port to solve the smoke problem. The operative time was ended in 50 minutes, and no peroperative complication was encountered. The patient was discharged at the second postoperative day. CONCLUSION: SILS Adrenalectomy is a safe procedure for a benign adrenal lesion in experienced hands. Further studies are needed to evaluate the special benefits of this technique.

Luigi Schips – One of the best experts on this subject based on the ideXlab platform.

  • laparo endoscopic single site left transperitoneal Adrenalectomy
    European Urology, 2010
    Co-Authors: Luca Cindolo, Stefano Gidaro, Fabiola Raffaella Tamburro, Luigi Schips
    Abstract:

    A 53-yr-old woman presented with abdominal pain. Ultrasonography, computed tomography, and an endocrinologic work-up revealed a 4-cm nonfunctional left adrenal mass. A TriPort laparoscopic Adrenalectomy was performed. The TriPort was inserted through a 3-cm subcostal incision. Using 5-mm instruments, a left Adrenalectomy was performed. The specimen was dissected (harmonic scalscalpel) and extracted through a 10-mm bag. A TriPort Adrenalectomy was successfully completed in 240 min (blood loss: 20 ml). The postoperative period was uneventful (discharge within 3 d). In our opinion, the TriPort Adrenalectomy is feasible and safe, with favourable perioperative and short-term outcomes and a delighted patient at the 8-mo follow-up.

Gerard M Doherty – One of the best experts on this subject based on the ideXlab platform.

  • resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more often after laparoscopic Adrenalectomy than after open Adrenalectomy
    Surgery, 2012
    Co-Authors: Barbra S Miller, Paul G Gauger, Gary D Hammer, Gerard M Doherty
    Abstract:

    Background Controversy surrounds the use of laparoscopy for resection of adrenocortical carcinoma. We evaluated the hypothesis that outcome is equivalent in patients undergoing laparoscopic Adrenalectomy versus open Adrenalectomy. Methods This is a retrospective review of 217 patients (156 patients with stage I–III cancer) with adrenocortical carcinoma referred to a single institution between 2005 and 2011. Outcome and operative data were assessed for the subset undergoing resection with curative intent. Student t and Fisher exact tests and the Kaplan–Meier method were used to compare data ( P ≤ .05 was considered statistically significant). Results One hundred fifty-six patients (64% female; median age, 47 years [range, 18–80]; median follow-up, 26.5 months [range, 1–188]) were identified. Forty-six patients underwent laparoscopic Adrenalectomy, and 110 underwent open Adrenalectomy. Twenty-seven percent of laparoscopic Adrenalectomy patients had stage III cancer. After laparoscopic Adrenalectomy, 30% had positive margins or intraoperative tumor spill compared to 16% of the open Adrenalectomy patients ( P = .04). Overall survival for patients with stage II cancer was longer in those undergoing open Adrenalectomy ( P  = .002). Time to visible tumor bed recurrence or peritoneal recurrence in stage II patients was shorter in laparoscopic Adrenalectomy patients ( P = .002). Conclusion Open Adrenalectomy is superior to laparoscopic Adrenalectomy for adrenocortical carcinoma based on completeness of resection, site and timing of initial tumor recurrence, and survival in stage II patients. Intraoperative evaluation is insensitive for the detection of stage III tumors.

  • Laparoscopic Adrenalectomy compared to open Adrenalectomy for benign adrenal neoplasms.
    Journal of the American College of Surgeons, 1996
    Co-Authors: L. M. Brunt, Gerard M Doherty, Jeffrey A. Norton, Nathaniel J. Soper, Mary A. Quasebarth, Jeffrey F. Moley
    Abstract:

    BACKGROUND Laparoscopic Adrenalectomy has recently been used for removing a variety of adrenal neoplasms. The purpose of the present study was to compare results and outcomes in patients who underwent either laparoscopic or open Adrenalectomy at our institution from 1988 to the present. STUDY DESIGN The records of 66 consecutive patients with benign adrenal neoplasms who underwent Adrenalectomy from 1988 through 1995 were retrospectively reviewed. Patients were divided into three groups based on the operative approach: group I (n = 25), open anterior transabdominal approach; group II (n = 17), open posterior retroperitoneal approach; and group III (n = 24), laparoscopic transabdominal flank approach. Various parameters were compared and statistical analyses were performed. RESULTS The three groups were similar in age, gender, American Society of Anesthesiologists class, and distribution of unilateral compared with bilateral Adrenalectomy. Mean tumor size was slightly larger in group I (3.4 +/- 1.4 cm) than in group II (2.4 +/- 1.4 cm) or group III (2.7 +/- 1.4 cm) (p = NS). Mean operative times for unilateral Adrenalectomy were 142 +/- 38 minutes in group I, 136 +/- 34 minutes in group II, and 183 +/- 35 minutes in group III (p < 0.001, groups I and II compared with group III). For bilateral Adrenalectomy, mean operative times were 205 +/- 71 minutes (group I), 328 +/- 11 minutes (group II), and 422 +/- 77 minutes (group III). Patients who underwent laparoscopic Adrenalectomy had significantly less operative blood loss (mean, 104 mL compared to 408 mL in group I and 366 mL in group II, p < 0.001) and a lower incidence of perioperative blood trantransfusion. Laparoscopic Adrenalectomy was also associated with significantly reduced parenteral pain medication requirements (p < or = 0.001) and more rapid resumption of a regular diet (p < or = 0.01) compared to open Adrenalectomy. Postoperative length of stay was significantly longer in group I (8.7 +/- 4.5 days) and in group II (6.2 +/- 3.9 days) after open Adrenalectomy than after laparoscopic Adrenalectomy (3.2 +/- 0.9 days) (p < 0.01). Total hospital charges were similar for groups II and III but somewhat higher for group I. Patients were able to resume 100 percent activity an average of 10.6 +/- 4.9 days after laparoscopic Adrenalectomy and returned to work a mean of 16.0 +/- 6.1 days postoperatively. CONCLUSIONS Laparoscopic Adrenalectomy is a safe and effective procedure and has several advantages over open Adrenalectomy. Laparoscopic Adrenalectomy should become the preferred operative approach for the treatment of patients with small, benign adrenal neoplasms.

Tarik Terzioglu – One of the best experts on this subject based on the ideXlab platform.

  • Single-incision laparoscopic Adrenalectomy
    Surgical endoscopy, 2011
    Co-Authors: Fatih Tunca, Yasemin Giles Senyurek, Tarik Terzioglu, Yalın İşcan, Serdar Tezelman
    Abstract:

    Background The aim of this study was to compare outcome measures between conventional transabdominal laparoscopic Adrenalectomy and single-incision laparoscopic Adrenalectomy (SILA).

  • Single-incision laparoscopic left Adrenalectomy.
    Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2010
    Co-Authors: Fatih Tunca, Yasemin Giles Senyurek, Tarik Terzioglu, İsmail Cem Sormaz, Serdar Tezelman
    Abstract:

    BACKGROUND: Single-incision laparoscopic surgery (SILS) has gained an interest and popularity in the recent years. Although minimally invasive adrenal surgery replaced the open Adrenalectomy, SILS Adrenalectomy is a step forward technique that improves the cosmesis, decreases acsess related morbidity, and increases the postoperative recovery. We report our first experience with single-incision transperitoneal left Adrenalectomy in a patient with Conns’ syndrome. CASE: A 46-year-old female patient with a diagnosis of Conns’ syndrome underwent single-incision transperitoneal laparoscopic left Adrenalectomy. SILS port (Covidien, Norwalk, CT) was used through a 2-cm incision and additional one 5-mm trocar used through one of the holes of SILS port to solve the smoke problem. The operative time was ended in 50 minutes, and no peroperative complication was encountered. The patient was discharged at the second postoperative day. CONCLUSION: SILS Adrenalectomy is a safe procedure for a benign adrenal lesion in experienced hands. Further studies are needed to evaluate the special benefits of this technique.