Left adrenalectomy, laparoscopic - general and visceral surgery

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  • CT findings

    CT findings
     

    Imaging demonstrates a multinodular 5cm–6cm large cyst-like mass in the region of the left adrenal, clinically confirmed as pheochromocytoma.

  • Trocar positioning

    Trocar positioning
     

    Perform medial 2cm long minilaparotomy in left upper quadrant for the trocar of the laparoscope and then initiate pneumoperitoneum. After exploration of the abdominal cavity introduce two more working trocars – one 5mm trocar in the left upper quadrant and a Versa-Port V12 anterior to the 11thrib.

  • Freeing the descending colon

    Video
     
    Freeing the descending colon
     

    Pull the descending colon mediad and incise the retroperitoneum in the avascular plane anterior to the left kidney.

  • Opening the prerenal space

    Video
     
    Opening the prerenal space
     
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  • Dissecting the spleen off the diaphragm

    Video
     
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  • Exposing the superior left retroperitoneum

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  • Accessing the adrenal

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  • Mobilizing the adrenal tumor

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  • Transecting the central suprarenal vein

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  • Transecting the arterial blood supply

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  • Removing the entire adrenal

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  • Retrieving the specimen and placing a drain

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  • Wound closure

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  1. CT findings
  2. Trocar positioning
  3. Freeing the descending colon
  4. Opening the prerenal space
  5. Dissecting the spleen off the diaphragm
  6. Exposing the superior left retroperitoneum
  7. Accessing the adrenal
  8. Mobilizing the adrenal tumor
  9. Transecting the central suprarenal vein
  10. Transecting the arterial blood supply
  11. Removing the entire adrenal
  12. Retrieving the specimen and placing a drain
  13. Wound closure
date of update: 01.10.2022
date of publication: 20.05.2012

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