چکیده (انگلیسی):

Background: We previously reported our initial experience with laparoendoscopic
single-site (LESS) retroperitoneal partial adrenalectomy using a custom-made single-port device
and conventional straight laparoscopic instruments.
Methods: Between December 2010 and February 2012, LESS retroperitoneal partial adrenalectomies
were performed in 11 patients. Six patients had aldosterone-producing adenomas
(APAs) and five patients had nonfunctioning tumors. A single-port access was created with
an Alexis wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA) through an incision
of 2e3 cm beneath the tip of the 12th rib. All procedures were performed with straight
laparoscopic instruments.
Results: All LESS procedures were successfully completed without conversion to traditional laparoscopic
conversion. The tumors ranged from 1 cm to 4.7 cm (mean, 2.3 cm). The operative time
was 71e257 minutes (mean, 121 minutes). Most patients (nZ8) had minimal blood loss; the other
three patients had a blood loss of 150 mL, 100 mL, and 100 mL. The mean hospital stay was 3 days
(range, 1e6 days). There were no perioperative or postoperative complications. Pathological examinations
revealed negative surgical margins in all specimens. All patients with Conn’s syndrome
had an improvement in blood pressure and normalization of plasma renin activity and
serum aldosterone levels; all patients were free of potassium supplementation.
Conclusion: Our results clearly demonstrate that LESS retroperitoneal partial adrenalectomy
can be performed safely and effectively using a custom-made single-access platform and standard
laparoscopic instruments.