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Transabdominal Laparoscopic Left Adrenalectomy

  • Frederick Thurston DrakeEmail author
  • Quan-Yang Duh
Chapter

Abstract

The patient with a left adrenal mass (Figs. 1.1 and 1.2) is intubated and then placed into the right lateral decubitus position with all pressure points padded. Both arms are partially extended into a comfortable “hugging” configuration with the right arm placed on a padded arm board and the left arm positioned on pillows or an elevated arm board. An axillary roll is placed just caudal to the right axilla to prevent brachial plexus palsy. We generally position the patient so he or she is reclining slightly more supine than in full decubitus position. The left flank is exposed, and the right lower ribs should be placed overlying the “break” in the operating table; this ensures that, when the table is flexed, the space between costal margin and iliac crest widens, allowing more working room for the laparoscopic instruments. Conceptually, the patient is positioned so that the upper pole of the kidney is placed on top of the break in the bed.

Keywords

Adrenalectomy  Laparoscopic  Transabdominal 

Supplementary material

Video 1.1a

Transabdominal laparoscopic left adrenalectomy (MP4 549454 kb)

Video 1.1b

Transabdominal laparoscopic left adrenalectomy (MP4 539023 kb)

Video 1.1c

Transabdominal laparoscopic left adrenalectomy (MP4 581977 kb)

Suggested Reading

  1. Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016;175(2):G1–G34.CrossRefGoogle Scholar
  2. Gagner M, Pomp A, Heniford BT, Pharand D, Lacroix A. Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. Ann Surg. 1997;226(3):238–46.CrossRefGoogle Scholar
  3. Scholten A, Cisco RM, Vriens MR, Shen WT, Duh QY. Variant adrenal venous anatomy in 546 laparoscopic adrenalectomies. JAMA Surg. 2013;148(4):378–83.CrossRefGoogle Scholar
  4. Seiser N, Duh QY. Laparoscopic adrenalectomy: transperitoneal approach. In: Clark OH, Duh QY, Gosnell JE, Kebebew E, Shen WT, editors. Textbook of endocrine surgery. 3rd ed. Philadelphia: Jaypee Brothers Medical Publishers; 2016.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryBoston University School of MedicineBostonUSA
  2. 2.Department of SurgeryUniversity of California, San Francisco Mt. Zion Medical CenterSan FranciscoUSA

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