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Erschienen in: Updates in Surgery 4/2021

29.10.2020 | Original Article

Mini-laparoscopic adrenalectomy with transgastric specimen extraction

verfasst von: Fatih Sumer, Yusuf Murat Bag, Mehmet Can Aydin, Bahri Evren, Emine Sener Aydin, Ibrahim Sahin, Cuneyt Kayaalp

Erschienen in: Updates in Surgery | Ausgabe 4/2021

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Abstract

We aimed to describe the initial experience of mini-laparoscopic adrenalectomy combined with transgastric specimen extraction and to assess its safety and feasibility. We used only 5-mm trocars, three ports for left adrenalectomy and four for right. Intraoperative gastroscopy was performed for specimen extraction through the mouth via an endoscopic snare. The gastrotomy was closed intracorporeally. Demographic, perioperative and pathological data were analyzed. There were 16 patients (12 females) with the mean age of 46.5 ± 11.3 years and half of them had previous abdominal surgeries. The median operative time was 150 (45–432) min with a median blood loss of 88 (0–350) ml. The median oral intake time was 2 (1–4) days and the median length of hospital stay was 2 (2–5) days. There was no mortality and extraction-related complication. Histopathological median tumor length, width and depth were 3 cm, 2.15 cm, and 1.9 cm, respectively. The median specimen length, width and depth were 6.25 cm, 4 cm, and 2.2 cm, respectively. Mini-laparoscopic adrenalectomy combined with transgastric specimen extraction is a safe and feasible surgical technique. It provides a less invasive surgery and may also have some benefits on wound-related complications and cosmesis.
Literatur
2.
Zurück zum Zitat Akarsu C, Dural AC, Kankaya B, Celik MF, Kones O, Mert M, Kalayci MU, Alis H (2014) The early results of our initial experience with robotic adrenalectomy. Ulus Cerrahi Derg 30(1):28–33PubMedPubMedCentral Akarsu C, Dural AC, Kankaya B, Celik MF, Kones O, Mert M, Kalayci MU, Alis H (2014) The early results of our initial experience with robotic adrenalectomy. Ulus Cerrahi Derg 30(1):28–33PubMedPubMedCentral
3.
Zurück zum Zitat Salgaonkar H, Parameswaran R (2019) Adrenal natural orifice transluminal endoscopic surgery (NOTES): a step too far? Gland Surg 8(Suppl 1):S17–S21CrossRefPubMedPubMedCentral Salgaonkar H, Parameswaran R (2019) Adrenal natural orifice transluminal endoscopic surgery (NOTES): a step too far? Gland Surg 8(Suppl 1):S17–S21CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Hirasawa Y, Miyajima A, Hattori S, Miyashita K, Kurihara I, Shibata H, Kikuchi E, Nakagawa K, Oya M (2014) Laparoendoscopic single-site adrenalectomy versus conventional laparoscopic adrenalectomy: a comparison of surgical outcomes and an analysis of a single surgeon’s learning curve. Surg Endosc 28(10):2911–2919CrossRefPubMed Hirasawa Y, Miyajima A, Hattori S, Miyashita K, Kurihara I, Shibata H, Kikuchi E, Nakagawa K, Oya M (2014) Laparoendoscopic single-site adrenalectomy versus conventional laparoscopic adrenalectomy: a comparison of surgical outcomes and an analysis of a single surgeon’s learning curve. Surg Endosc 28(10):2911–2919CrossRefPubMed
5.
Zurück zum Zitat Ji C, Lu Q, Chen W, Zhang F, Ji H, Zhang S, Zhao X, Li X, Zhang G, Guo H (2020) Retrospective comparison of three minimally invasive approaches for adrenal tumors: perioperative outcomes of transperitoneal laparoscopic, retroperitoneal laparoscopic and robot-assisted laparoscopic adrenalectomy. BMC Urol 20(1):66CrossRefPubMedPubMedCentral Ji C, Lu Q, Chen W, Zhang F, Ji H, Zhang S, Zhao X, Li X, Zhang G, Guo H (2020) Retrospective comparison of three minimally invasive approaches for adrenal tumors: perioperative outcomes of transperitoneal laparoscopic, retroperitoneal laparoscopic and robot-assisted laparoscopic adrenalectomy. BMC Urol 20(1):66CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Karabulut K, Agcaoglu O, Aliyev S, Siperstein A, Berber E (2012) Comparison of intraoperative time use and perioperative outcomes for robotic versus laparoscopic adrenalectomy. Surgery 151(4):537–542CrossRefPubMed Karabulut K, Agcaoglu O, Aliyev S, Siperstein A, Berber E (2012) Comparison of intraoperative time use and perioperative outcomes for robotic versus laparoscopic adrenalectomy. Surgery 151(4):537–542CrossRefPubMed
7.
Zurück zum Zitat Zou X, Zhang G, Xiao R, Yuan Y, Wu G, Wang X, Long D, Wu Y, Liu M, Xue Y, Zhang X (2011) Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience. Surg Endosc 25(12):3767–3772CrossRefPubMed Zou X, Zhang G, Xiao R, Yuan Y, Wu G, Wang X, Long D, Wu Y, Liu M, Xue Y, Zhang X (2011) Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience. Surg Endosc 25(12):3767–3772CrossRefPubMed
8.
Zurück zum Zitat Mercan S, Seven R, Ozarmagan S, Tezelman S (1995) Endoscopic retroperitoneal adrenalectomy. Surgery 118(6):1071–1075CrossRefPubMed Mercan S, Seven R, Ozarmagan S, Tezelman S (1995) Endoscopic retroperitoneal adrenalectomy. Surgery 118(6):1071–1075CrossRefPubMed
9.
Zurück zum Zitat Wang L, Liu B, Wu Z, Yang Q, Chen W, Sheng H, Xu Z, Xiao L, Wang C, Sun Y (2012) Comparison of single-surgeon series of transperitoneal laparoendoscopic single-site surgery and standard laparoscopic adrenalectomy. Urology 79(3):577–583CrossRefPubMed Wang L, Liu B, Wu Z, Yang Q, Chen W, Sheng H, Xu Z, Xiao L, Wang C, Sun Y (2012) Comparison of single-surgeon series of transperitoneal laparoendoscopic single-site surgery and standard laparoscopic adrenalectomy. Urology 79(3):577–583CrossRefPubMed
10.
Zurück zum Zitat Halim I, Tavakkolizadeh A (2008) NOTES: the next surgical revolution? Int J Surg 6(4):273–276CrossRefPubMed Halim I, Tavakkolizadeh A (2008) NOTES: the next surgical revolution? Int J Surg 6(4):273–276CrossRefPubMed
11.
Zurück zum Zitat Dostalik J, Gunkova P, Gunka I, Mazur M, Mrazek T (2014) Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis. Wideochir Inne Tech Maloinwazyjne 9(2):282–285PubMedPubMedCentral Dostalik J, Gunkova P, Gunka I, Mazur M, Mrazek T (2014) Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis. Wideochir Inne Tech Maloinwazyjne 9(2):282–285PubMedPubMedCentral
12.
Zurück zum Zitat Kayaalp C (2014) Minilaparoscopy combined with natural orifice surgery: benefits can be beyond the cosmesis. J Nippon Med Sch 81(6):406CrossRefPubMed Kayaalp C (2014) Minilaparoscopy combined with natural orifice surgery: benefits can be beyond the cosmesis. J Nippon Med Sch 81(6):406CrossRefPubMed
13.
Zurück zum Zitat Helgstrand F, Rosenberg J, Bisgaard T (2011) Trocar site hernia after laparoscopic surgery: a qualitative systematic review. Hernia 15(2):113–121CrossRefPubMed Helgstrand F, Rosenberg J, Bisgaard T (2011) Trocar site hernia after laparoscopic surgery: a qualitative systematic review. Hernia 15(2):113–121CrossRefPubMed
14.
Zurück zum Zitat Jurczak F, Pousset JP (2010) Laparoscopic cholecystectomy combined using miniaturised instruments in transgastric gall bladder removal: performed on 63 patients. Minim Invasive Surg 2:582763 Jurczak F, Pousset JP (2010) Laparoscopic cholecystectomy combined using miniaturised instruments in transgastric gall bladder removal: performed on 63 patients. Minim Invasive Surg 2:582763
15.
Zurück zum Zitat Sumer F, Kayaalp C, Polat Y, Ertugrul I, Karagul S (2016) Transgastric removal of a polycystic liver disease using mini-laparoscopic excision. Interv Med Appl Sci 8(2):89–92PubMedPubMedCentral Sumer F, Kayaalp C, Polat Y, Ertugrul I, Karagul S (2016) Transgastric removal of a polycystic liver disease using mini-laparoscopic excision. Interv Med Appl Sci 8(2):89–92PubMedPubMedCentral
16.
Zurück zum Zitat Fritscher-Ravens A, Ghanbari A, Cuming T, Kahle E, Niemann H, Koehler P, Patel K (2008) Comparative study of NOTES alone vs. EUS-guided NOTES procedures. Endoscopy 40(11):925–930CrossRefPubMed Fritscher-Ravens A, Ghanbari A, Cuming T, Kahle E, Niemann H, Koehler P, Patel K (2008) Comparative study of NOTES alone vs. EUS-guided NOTES procedures. Endoscopy 40(11):925–930CrossRefPubMed
17.
Zurück zum Zitat Huang C, Huang RX, Qiu ZJ (2011) Natural orifice transluminal endoscopic surgery: new minimally invasive surgery come of age. World J Gastroenterol 17(39):4382–4388CrossRefPubMedPubMedCentral Huang C, Huang RX, Qiu ZJ (2011) Natural orifice transluminal endoscopic surgery: new minimally invasive surgery come of age. World J Gastroenterol 17(39):4382–4388CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Dotai T, Coker AM, Antozzi L, Acosta G, Michelotti M, Bildzukewicz N, Sandler BJ, Jacobsen GR, Talamini MA, Horgan S (2013) Transgastric large-organ extraction: the initial human experience. Surg Endosc 27(2):394–399CrossRefPubMed Dotai T, Coker AM, Antozzi L, Acosta G, Michelotti M, Bildzukewicz N, Sandler BJ, Jacobsen GR, Talamini MA, Horgan S (2013) Transgastric large-organ extraction: the initial human experience. Surg Endosc 27(2):394–399CrossRefPubMed
19.
Zurück zum Zitat Ramamoorthy SL, Lee JK, Luo L, Mintz Y, Cullen J, Easter DW, Savu MK, Chock A, Carethers J, Horgan S, Talamini MA (2010) The inflammatory response in transgastric surgery: gastric content leak leads to localized inflammatory response and higher adhesive disease. Surg Endosc 24(3):531–535CrossRefPubMed Ramamoorthy SL, Lee JK, Luo L, Mintz Y, Cullen J, Easter DW, Savu MK, Chock A, Carethers J, Horgan S, Talamini MA (2010) The inflammatory response in transgastric surgery: gastric content leak leads to localized inflammatory response and higher adhesive disease. Surg Endosc 24(3):531–535CrossRefPubMed
Metadaten
Titel
Mini-laparoscopic adrenalectomy with transgastric specimen extraction
verfasst von
Fatih Sumer
Yusuf Murat Bag
Mehmet Can Aydin
Bahri Evren
Emine Sener Aydin
Ibrahim Sahin
Cuneyt Kayaalp
Publikationsdatum
29.10.2020
Verlag
Springer International Publishing
Erschienen in
Updates in Surgery / Ausgabe 4/2021
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-020-00904-5

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