Journal of Minimal Access Surgery

ORIGINAL ARTICLE
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Year : 2006  |  Volume : 2  |  Issue : 2  |  Page : 59--66

Laparoscopic adrenalectomy: Gaining experience by graded approach

Abhay N Dalvi1, Pinky M Thapar1, K Vijay Kumar1, Ranjeet S Kamble1, Sameer A Rege1, Aparna A Deshpande1, Nalini S Shah2, Padma S Menon2 
1 Departments of General Surgery, Seth G S Medical College & KEM Hospital, Mumbai - 400 012, India
2 Departments of Endocrinology, Seth G S Medical College & KEM Hospital, Mumbai - 400 012, India

Correspondence Address:
Abhay N Dalvi
257 Walkeshwar Road, Mumbai - 400 006
India

INTRODUCTION: Laparoscopic adrenalectomy (LA) has become a gold standard in management of most of the adrenal disorders. Though report on the first laparoscopic adrenalectomy dates back to 1992, there is no series of LA reported from India. Starting Feb 2001, a graded approach to LA was undertaken in our center. Till March 2006, a total of 34 laparoscopic adrenalectomies were performed with success. MATERIALS AND METHODS: The endocrinology department primarily evaluated all patients. Patients were divided into Group A - unilateral LA and Group B - bilateral LA (BLA). The indications in Group A were pheochromocytoma (n=7), Conn俟Q製 syndrome (n=3), Cushing俟Q製 adenoma (n=2), incidentaloma (n=2); and in Group B, Cushing俟Q製 disease (CD) following failed trans-sphenoid pituitary surgery (n = 8); ectopic ACTH- producing Cushing俟Q製 syndrome (n=1) and congenital adrenal hyperplasia (CAH) (n=1). The lateral transabdominal route was used. RESULTS: The age group varied from 12-54 years, with mean age of 28.21 years. Average duration of surgery in Group A was 166.43 min (40-270 min) and 190 min (150- 310 min) in Group B. Average blood loss was 136.93 cc (20-400 cc) in Group A and 92.5 cc (40-260 cc) in Group B. There was one conversion in each group. Mean duration of surgical stay was 1.8 days (1-3 days) in Group A and 2.6 days (2-4 days) in Group B. All the patients in both groups were cured of their illness. Three patients in Group B developed Nelson俟Q製 syndrome. The mean follow up was of 24.16 months (4-61 months). CONCLUSION: LA though technically demanding, is feasible and safe. Graded approach to LA is the key to success.


How to cite this article:
Dalvi AN, Thapar PM, Vijay Kumar K, Kamble RS, Rege SA, Deshpande AA, Shah NS, Menon PS. Laparoscopic adrenalectomy: Gaining experience by graded approach.J Min Access Surg 2006;2:59-66


How to cite this URL:
Dalvi AN, Thapar PM, Vijay Kumar K, Kamble RS, Rege SA, Deshpande AA, Shah NS, Menon PS. Laparoscopic adrenalectomy: Gaining experience by graded approach. J Min Access Surg [serial online] 2006 [cited 2021 Jan 26 ];2:59-66
Available from: https://www.journalofmas.com/article.asp?issn=0972-9941;year=2006;volume=2;issue=2;spage=59;epage=66;aulast=Dalvi;type=0