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Laparoscopic organ preserving resection of two pheochromocytes from a single left adrenal gland

Laparoscopic organ preserving resection of two pheochromocytes from a single left adrenal gland.

Professor Puchkov K.V. is performing an operation (2019).

Patient 24 years old, in the single left adrenal gland were found two tumors about 2 cm each in diameter, they located in the medial pedicle and in the body of the organ. At the age of 20, he was examined about hypertensive crises. In 2015, bilateral adrenal lesions were diagnosed: on the right a tumor - up to 5 cm, on the left side - 2 lesions: 1 and 1.5 cm. Right-sided adrenalectomy was performed, the histological conclusion was: malignant pheochromocytoma. The patient refused bilateral adrenalectomy. In the future, according to CT data, the growth of lesions of the left adrenal gland is noted. In the analyzes: daily urine metanephrins: maximum metanephrine 8.897 mg/day, normetanephrine 319.3 mg/day. In the preoperative period, he received «Cardura». A laparoscopic organ-sparing surgery was performed - removal of two formations with full preservation of the adrenal tissue. Access to the adrenal gland was done by mobilising the splenic angle of the colon and dissecting the tissue between the Tolds fascia and Herota fascia. The intersection of the vascular structures and adrenal tissue is performed by alternating ligation systems — 5 mm Thunderbeat Olympus instrument and 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The operation is carried out quickly and bloodless. The tumor is cut off from the body of the adrenal gland and placed in a plastic container in which was removed from the abdominal cavity. For the hemostasis «Tachocombe» was used at the sites of tumor removal. The operation time was 40 minutes. Histology - pheochromocytoma of solid-alveolar structure with polymorphoncellular composition.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Laparoscopic left-sided partial adrenalectomy for pheochromocytoma

Laparoscopic left-sided partial adrenalectomy for pheochromocytoma.
Professor Puchkov K.V. is performing an operation (2018).

Patient 37 years old, was admitted with a tumor of the left adrenal gland, 4 cm in diameter, located in the lateral pedicle. BMI - 32.3. In the analyzes was found out the increase of urine metanephrine: metanephrine 460 mcg / day (up to 320), normetanephrine 595 mcg / day (up to 390), cortisol and aldosterone were within normal limits. In the preoperative period she received «Cardura». A laparoscopic organ-sparing surgery was performed - left partial adrenalectomy. Access to the adrenal gland is accomplished by dissecting the splenic angle of the colon and dissecting the tissue between the fascia of Toldt and Herot. The intersection of the vascular structures and adrenal tissue was performed by alternating the ligation systems — 5 mm Thunderbeat Olympus instrument and 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The operation was carried out quickly and bloodless. The tumor was cut off from the body of the adrenal gland and placed in a plastic container in which it was removed from the abdominal cavity.
Additional hemostasis was carried out by the PerClot system (Italy). The operation time was 40 minutes.
Histology - adrenal pheochromocytoma

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Laparoscopic right-side partial adrenalectomy for pheochromocytoma

Laparoscopic right-side partial adrenalectomy for pheochromocytoma.
Professor Puchkov K.V. is performing an operation (2018).

Patient 44 years old, was admitted with a tumor of the right adrenal gland about 6 cm in size located in its body. In the analyzes, was found out the increase of urine metanephrine: metanephrine 429 µg / day (up to 320), normetanephrine 695 µg / day (up to 390), cortisol and aldosterone were within normal limits. In the preoperative period she received «Cardura». Concomitant chronic calculous cholecystitis. A laparoscopic organ-sparing surgery was performed - partial adrenalectomy and cholecystectomy. Access to the adrenal gland was performed by dissecting the tissue between the fascia of Tolda and Gerot. The intersection of the vascular structures and adrenal tissue was performed by alternating the ligation systems — 5 mm Thunderbeat Olympus instrument and 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The tumor was cut off from the body of the adrenal gland and placed in a plastic container in which it was removed from the abdominal cavity. Operation time 45 minutes.
The operation was carried out quickly and bloodless. Additional hemostasis was carried out by the PerClot system (Italy). At the end of the film, a removed specimen is shown - the adrenal pheochromocytoma (6 cm). Histology - the adrenal pheochromocytoma.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Laparoscopic right-sided enucleation of adrenal tumor for pheochromocytoma

Laparoscopic right-sided enucleation of adrenal tumor for pheochromocytoma.

Professor Puchkov K.V. is performing an operation (2018).

Patient 53 years old was admitted to the hospital, it was found a 3 cm tumor of the right adrenal gland, located in the medial pedicle. The patient noted a history of hypertensive crises. A laparoscopic organ-sparing surgery was performed - right-sided enucleation of the tumor. Access to the adrenal gland was done by dissecting the tissue between the Tolds fascia and Herota fascia. The intersection of the vascular structures and adrenal tissue was performed by alternating the ligation systems — 5 mm Thunderbeat Olympus instrument and 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The tumor was cut off from the body of the adrenal gland and placed in a plastic container in which was removed from the abdominal cavity. The operation time was 30 minutes.
The operation was carried out quickly and bloodless. Additional hemostasis was carried out by the PerClot system (Italy). At the end of the film, the removed specimen is shown - adrenal pheochromocytoma (3 cm).
Histology - adrenal pheochromocytoma.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Laparoscopic partial adrenalectomy, using Thunderbeat system and PerClot hemostatic

Laparoscopic partial adrenalectomy, using Thunderbeat system and PerClot hemostatic.

Professor Puchkov K.V. is performing an operation (2012).

The operation is performed for benign tumour of the adrenal gland (the diameter is 6 cm), it is located in the lateral pedicle. In this film the technique of organopreserving operation, dissection of tissues by endoscopic scissors with the exposure of the inferior vena cava and adrenal vein is presented. Transection of the vascular structures and tissue of the adrenal gland is performed by a 5 mm Thunderbeat Olympus instrument. The operation is performed fast and without blood loss. Operation duration is 25 minutes. Additional hemostasis is done by PerClot system (Italy).

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Laparoscopic partial adrenalectomy

Laparoscopic partial adrenalectomy.
Professor Puchkov K.V. is performing an operation (2012).

The operation is performed for benign tumour of the adrenal gland, having the diameter 12 cm. In this film the technique of organopreserving operation, dissection of tissues with the help of endoscopic scissors and exposure of the inferior vena cava and adrenal vein is presented. Transection of the vascular structures and tissue of the adrenal gland is performed by a 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The use of modern ligating systems gives a possibility not to perform an additional hemostasis of the stump of the adrenal gland and not to leave drainage in the abdominal cavity.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

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