Laparoscopic Transperitoneal Adrenalectomy Using the LigaSure™ Vessel Sealing System
- 1 December 2005
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Laparoendoscopic & Advanced Surgical Techniques
- Vol. 15 (6), 591-595
- https://doi.org/10.1089/lap.2005.15.591
Abstract
Background: Laparoscopic adrenalectomy is being performed with increasing frequency in the surgical treatment of adrenal tumors. Among laparoscopic approaches to the adrenal glands, the transperitoneal access is preferred. Along with advances in technology, different energy systems have been utilized. Laparoscopic adrenalectomy has become easier with the use of the LigaSure™ vessel sealing system (Valleylab, Boulder, Colorado). Materials and Methods: Between January 2002 and August 2004, 23 laparoscopic transperitoneal adrenalectomies were performed in 22 patients using the LigaSure vessel sealing system: 16 of the patients were female, 6 were male and the mean age was 44 years (range, 17–70 years). Indications for surgery were non-functioning adenoma (n = 10), pheochromocytoma (n = 4), Cushing's syndrome (n = 5), Conn's syndrome (n = 2), and lymphoma (n = 1). The mean diameter of lesions was 4 cm (range, 1–7 cm). The distribution was 12 left, 9 right, and 1 bilateral adrenalectomies. Results: The mean operative time for unilateral adrenalectomies was 57 minutes (range, 30–75 minutes). The operative time for the patient with Cushing's disease in whom a bilateral adrenalectomy was performed was 180 minutes. All operations were completed laparoscopically. A nonsteroidal anti-inflammatory drug (Lornoxicam) was sufficient for postoperative analgesia. Oral feeding was started 6 hours postoperatively. When used, drains were removed on postoperative day 1. The mean postoperative hospital stay was 1.5 days (range, 1–3 days). Wound infections developed in two patients with Cushing's syndrome. There was no mortality. Histopathologic examination of specimens revealed a cortex adenoma in 16 cases (10 of which was nonfunctional), a pheochromocytoma in 4 cases, a bilateral cortical hyperplasia in 1 case, and a lymphoma in 1 case. Conclusion: Laparoscopic adrenalectomy is an established method in the treatment of adrenal masses. Laparoscopic adrenalectomy as well as other laparoscopic procedures has become easier with the introduction of new energy systems.Vascular control and dissection of the gland by Liga- Sure is feasible. It makes the procedure easier and eventually shortens the operation time.Keywords
This publication has 18 references indexed in Scilit:
- A new tissue-sealing technique using the ligasure system for nonanatomical pulmonary resection: preliminary results of sutureless and stapleless thoracoscopic surgeryThe Annals of Thoracic Surgery, 2004
- Laparoscopic Adrenalectomy for PheochromocytomaMayo Clinic Proceedings, 2003
- Quels sont les avantages de l’utilisation du système robotique DaVinci® pour réaliser une surrénalectomie unilatérale ? Résultats préliminairesAnnales de Chirurgie, 2003
- Laparoscopic adrenalectomy—indications and techniqueSurgical Oncology, 2003
- Section 3. Adrenal: Laparoscopic adrenalectomy: current status with a review of Japanese literatureBiomedicine & Pharmacotherapy, 2002
- Section 3. Adrenal: OverviewBiomedicine & Pharmacotherapy, 2002
- Laparoscopic splenectomy using ligasureSurgical Endoscopy, 2002
- Initial results with an electrothermal bipolar vessel sealerSurgical Endoscopy, 2001
- Recent innovations in bipolar electrosurgeryMinimally Invasive Therapy & Allied Technologies, 1999
- High-burst-strength, feedback-controlled bipolar vessel sealingSurgical Endoscopy, 1998