<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.1102.545_s_001_w2aab3b7b1b1b6b1aab1c15b1Aa"><h3>Background</h3><p>Laparoscopic adrenalectomy remains a challenging operation for pheochromocytoma (PCC) because of excessive secretion of catecholamines causing hemodynamic instability.</p></sec><sec id="j_1905-7415.1102.545_s_002_w2aab3b7b1b1b6b1aab1c15b2Aa"><h3>Objectives</h3><p>To evaluate the use of the LigaSure vessel sealing system (Covidien-Medtronic) to secure hemostasis during laparoscopic adrenalectomy for PCC.</p></sec><sec id="j_1905-7415.1102.545_s_003_w2aab3b7b1b1b6b1aab1c15b3Aa"><h3>Methods</h3><p>In this observational study we retrospectively reviewed a case series of 19 patients with preoperatively diagnosed PCC, who underwent laparoscopic adrenalectomy who underwent laparoscopic adrenalectomy using the LigaSure vessel sealing instead of using vascular clips or suturing. We report intraoperative findings, conversion rates, blood loss, operative time, morbidity, and postoperative outcomes.</p></sec><sec id="j_1905-7415.1102.545_s_004_w2aab3b7b1b1b6b1aab1c15b4Aa"><h3>Results</h3><p>Surgery was performed successfully for 18 patients. Surgery for the remaining 1 patient of the present case series was converted to open adrenalectomy because of surrounding tissue invasion. No mortality or major morbidity was observed. Estimated blood loss was a mean (range 20–300) 153 mL (excluding the loss in the patient whose surgery was converted to open adrenalectomy). The pathology showed 6 patients with potentially malignant PCC (Pheochromocytoma of the Adrenal Scaled Score (PASS) ≥ 4).</p></sec><sec id="j_1905-7415.1102.545_s_005_w2aab3b7b1b1b6b1aab1c15b5Aa"><h3>Conclusions</h3><p>The LigaSure device appears to be safe and effective in laparoscopic adrenalectomy for PCC. This clipless approach can be used with acceptable outcomes.</p></sec></abstract>

BackgroundLaparoscopic adrenalectomy remains a challenging operation for pheochromocytoma (PCC) because of excessive secretion of catecholamines causing hemodynamic instability.ObjectivesTo evaluate the use of the LigaSure vessel sealing system (Covidien-Medtronic) to secure hemostasis during laparoscopic adrenalectomy for PCC.MethodsIn this observational study we retrospectively reviewed a case series of 19 patients with preoperatively diagnosed PCC, who underwent laparoscopic adrenalectomy who underwent laparoscopic adrenalectomy using the LigaSure vessel sealing instead of using vascular clips or suturing. We report intraoperative findings, conversion rates, blood loss, operative time, morbidity, and postoperative outcomes.ResultsSurgery was performed successfully for 18 patients. Surgery for the remaining 1 patient of the present case series was converted to open adrenalectomy because of surrounding tissue invasion. No mortality or major morbidity was observed. Estimated blood loss was a mean (range 20–300) 153 mL (excluding the loss in the patient whose surgery was converted to open adrenalectomy). The pathology showed 6 patients with potentially malignant PCC (Pheochromocytoma of the Adrenal Scaled Score (PASS) ≥ 4).ConclusionsThe LigaSure device appears to be safe and effective in laparoscopic adrenalectomy for PCC. This clipless approach can be used with acceptable outcomes.

Clipless laparoscopic adrenalectomy for pheochromocytoma

Department of Surgery, Faculty of Medicine

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Clipless laparoscopic adrenalectomy for pheochromocytoma"}

BackgroundLaparoscopic adrenalectomy remains a challenging operation for pheochromocytoma (PCC) because of excessive secretion of catecholamines causing...

Authors	Patients	Mean operative time (min)	estimated blood loss (mL)	Conversion (%)	Morbidity (%)
Gagner (1996) [1]	23	230	–	0	22
Walz (2002) [28]	52	116	100	0	23
Jaroszewski (2003) [29]	47	140	80	11	4.8
Kim (2004) [30]	26	191	276	4	23
Kercher (2005) [31]	80	169	97	0	7.5
Naya (2005) [32]	23	193	130	4.34	0
Toniato (2007) [22]	40	78	100	3	2.5
Meyer-Rochow (2009) [33]	36	183	–	2.7	13.9
Castilho (2009) [34]	24	126	–	0	16.7
Nau (2010) [35]	33	142	–	12.1	6
Shen (2012) [36]	102	186	–	3	13.7
Conzo (2013) [27]	60	165	130	5	8.3
Present case series	19	114	153	5	10

Patients	19
Female	12
Male	7
Mean age (range) years
Side	37.8 (11-62)
Right	10
Left	10
Mean tumor size (range) cm	5.19 (1.9–10)
≤6 cm	15
>6 cm	5
Pheochromocytoma of the Adrenal Scaled Score (cases)
<4	14
≥4	6
Mean blood loss (range) mL	153 (20–300)
Mean operative time (range) min	114 (60–225)

Clipless laparoscopic adrenalectomy for pheochromocytoma

Article Category: Brief communication

Data publikacji: 31 sie 2017

Zakres stron: 157 - 162

DOI: https://doi.org/10.5372/1905-7415.1102.545

Słowa kluczowe
Clipless, laparoscopic adrenalectomy, LigaSure, pheochromocytoma, treatment outcome

© 2017 Apirak Santingamkun, Kamol Panumatrassamee, Prakorn Kiatsopit

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure

Results of laparoscopic adrenalectomy in patients with pheochromocytomas

Clinical characteristics of the patients and pheochromocytomas

Clipless laparoscopic adrenalectomy for pheochromocytoma

Article Category: Brief communication

Data publikacji: 31 sie 2017

Zakres stron: 157 - 162

DOI: https://doi.org/10.5372/1905-7415.1102.545

Słowa kluczoweClipless, laparoscopic adrenalectomy, LigaSure, pheochromocytoma, treatment outcome

© 2017 Apirak Santingamkun, Kamol Panumatrassamee, Prakorn Kiatsopit

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure

Results of laparoscopic adrenalectomy in patients with pheochromocytomas

Clinical characteristics of the patients and pheochromocytomas

Słowa kluczowe
Clipless, laparoscopic adrenalectomy, LigaSure, pheochromocytoma, treatment outcome