BookCarlos Eduardo Costa Almedia, editor.
Summary: This book will offer for the first time a step-by-step description of the posterior retroperitoneoscopic adrenalectomy, a minimally invasive technique, moving the gold standard of laparoscopic adrenalectomy towards the retroperitoneoscopic approach. Detailed information about the technique, the advantages over other approaches, the technical steps, the potential complications and how to solve them, outcomes, and robotics, will be offered to readers. This practical guide will be of great interest for all general surgeons and urologists already performing adrenal surgery, and for those that wish to start performing adrenalectomy.
Contents:
Intro
Preface
Contents
Contributors
Abbreviations
1: Anatomy of the Adrenal Gland
1.1 Introduction
1.2 The Adrenal Gland
1.2.1 Anatomical Landmarks and Topographic Anatomy
1.2.2 Arterial Supply
1.2.3 Venous Drainage
1.2.4 Lymphatic Drainage
1.2.5 Innervation
1.3 Anatomical Considerations in Posterior Retroperitoneoscopic Adrenalectomy
1.3.1 Retroperitoneum
1.3.2 Abdominal Wall (Posterior and Anterolateral)
References
2: Indications for Adrenalectomy
2.1 Introduction 2.2 Posterior Retroperitoneoscopic Adrenalectomy in Overproduction Adrenal Syndromes
2.2.1 Excessive Production of Aldosterone: Hyperaldosteronism
2.2.2 Excessive Production of Glucocorticoids: Cushing's Syndrome
2.2.3 Excessive Production of Catecholamines: Pheochromocytoma and Paraganglioma
2.3 Posterior Retroperitoneoscopic Adrenalectomy in Adrenal Malignancies
2.3.1 Adrenocortical Carcinoma
2.3.2 Malignant Pheochromocytoma and Paraganglioma
2.3.3 Metastases to the Adrenal Glands
2.4 Adrenal Incidentaloma
2.5 Partial Adrenalectomy
References 3: Open Versus Minimally Invasive Approach
3.1 Introduction
3.2 Validation of Laparoscopic Adrenal Surgery
3.3 Still a Place for Open
3.4 Open Surgery
3.4.1 Current Indications
3.4.2 Risk of Conversion to Open
3.5 Open Technique
3.5.1 Anterior Approach
3.5.1.1 Technique for the Right Side
3.5.1.2 Technique for the Left Side
3.5.2 Posterior Approach
3.5.3 Thoracoabdominal Approach
3.6 Conclusion
References
4: Retroperitoneoscopic Versus Laparoscopic Adrenalectomy
4.1 Background and Clinical Considerations
4.2 Intraoperative Outcomes 4.3 Postoperative Outcomes
References
5: Retroperitoneoscopic Approach in Malignant Disease
5.1 Introduction
5.2 Preoperative Evaluation of Patients with Adrenal Lesions Suspicious for Malignancy
5.3 Minimally Invasive Adrenal Surgery for Indeterminate Adrenal Nodules Suspicious for Malignancy
5.4 Minimally Invasive Adrenal Surgery for Metastatic Disease
5.5 Minimally Invasive Adrenal Surgery for Adrenocortical Carcinoma
References
6: Anesthesia in Posterior Retroperitoneoscopic Approach
6.1 Introduction
6.2 Preoperative Patient Evaluation 6.3 Anesthesia for PRA
6.4 Postoperative Pain Management
References
7: Technical Steps of Posterior Retroperitoneoscopic Adrenalectomy
7.1 Introduction
7.2 Surgical Instruments and Operation Table Setup
7.3 Surgical Team
7.4 Step-by-Step
7.4.1 Positioning the Patient
7.4.2 Placing the First Trocars (Balloon Trocar and Lateral Trocar)
7.4.3 Creating the Working Space
7.4.4 Placing the Third Trocar (Medial Trocar)
7.4.5 Finding Upper Pole of the Kidney
7.4.6 Finding the Inferior Vena Cava (IVC)
7.4.7 Dissecting and Ligating the Adrenal Vein