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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.



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