Right adrenalectomy, open - general and visceral surgery

You have not purchased a license - paywall is active: to the product selection
  • Laparotomy and exploration

    Transverse right laparotomy at the level of the umbilicus. After transecting the right rectus muscle with bipolar scissors and opening the peritoneum extend the incision in the midline to the xyphoid process. Explore the intestinal organs to rule out other metastases and confirm resectability.

  • Kocher maneuver mobilizing the duodenum

    Depending on the conditions in the field the right colic flexure may have to be freed. Follow this by mobilizing the descending duodenum until the inferior vena cava is exposed along its full length.

  • Exposing the right retroperitoneum and mobilizing the liver

    The posterior aspect the right adrenal abuts the diaphragm. The inferior aspect contacts the right kidney and the anteriosuperior aspect borders on the nude area of the liver. The anteromedial aspect of the right adrenal is posterior to the inferior vena cava. Paralleling the inferior vena cava open up the parietal peritoneum covering the anteroinferior aspect of the right adrenal.

    Transect the right triangular ligament before retracting the liver craniad. Now transect the adhesions between the inferior aspect of the liver and the adrenal. The perineoplastic inflammatory reaction will have resulted in intimate contact.

    Note: Surgical procedures on the right retroperitoneum are more difficult than on the left side because enlargement of the liver, obesity and barrel chest may make visualization and control of the surgical field quite difficult.

  • Exposing the inferior vena cava

    Paid content (video)
    Paid content (text)
  • Separating right adrenal and kidney

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Transecting the adrenal vein

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Posterocaval dissection of the adrenal tumor

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Specimen removal

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Closing the diaphragm and sealing the liver

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Drainage and closing the abdominal wall

    Paid content (video)
    Paid content (text)
date of update: 01.10.2022
date of publication: 15.08.2013

Single Access

Access to this lecture
for 3 days

€4.99 inclusive VAT

SEPA Maestro Mastercard VISA PayPal

webop-Account Single

full access to all lectures
price per month

for the modul: vascular surgery

from 8,17 €

hospitals & libraries

for the modul: vascular surgery

from 390,00 euros