[...]... Borrelli D (20 01) Adrenal masses in neoplastic patients: the role of laparoscopic procedure Surg Endosc 15 :90±93 1. 2 Retroperitoneal Laparoscopic Adrenalectomy for Malignancy Simon V Bariol, David A Tolley Contents Introduction 11 Patient Selection 11 Indications 11 Contraindications 11 Preoperative Preparation 12 Specific Investigations 12 Informed Consent 12 Preoperative Preparation 12 Technique 12 Description... Description 12 Anaesthetic Considerations 12 Patient Positioning 12 Retroperitoneal Access 12 Trocar Placement 13 Initial Dissection 13 Control of Adrenal Vein 13 Adrenal Mobilisation 14 Specimen Retrieval 14 Wound Closure 14 Technical Modifications 14 Postoperative Care 14 Technical Tips 15 Peritoneal Injury 15 Trocar Placement 15 Fourth Trocar 15 Obese Patients 15 Ribbon Gauze 15 Complications 15 Intraoperative... Table 1 Results of major clinical series in laparoscopic adrenalectomy for malignancies Author No of cases Elashry et al 19 97 [6] 2 Suzuki et al 19 97 [11 ] 2 Heniford et al 19 99 [8]a 12 Valeri et al 20 01 [23] 6 Kebebew et al 2002 [9] 20 9 Guazzoni b TOTAL 51 a b Primary Metastatic Mean lesion diameter (cm) Operative time (min) Conversion (no of cases/%) 0 1 1 0 5 3 10 2 1 11 6 15 6 41 6 5 5.9 4.5 5 .1 3.5... Billaud L (19 90) Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy N Engl J Med 322 :19 95±2000 14 Belldegrun A, deKernion JB (19 89) What to do about the incidentally found adrenal mass World J Urol 7 :11 7 12 0 15 Vassilopoulou-Sellin R, Schultz PN (20 01) Adrenocortical carcinoma: clinical outcome at the end of the 20th century Cancer 92 :11 13 11 21 16 Kim... Spain Mihir M Desai, MD Section of Laparoscopic and Minimally Invasive Surgery Glickman Urological Institute A100, Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland, OH 4 419 5, USA Franœois Desgrandchamps, MD Department of Urology HÖpital Saint-Louis 1 Avenue Claude Vellefaux 75 010 Paris, France List of Contributors Antonio Finelli, MD, MSc, FRCSC Section of Laparoscopic and Minimally Invasive Surgery. .. from non-small cell lung cancer improve survival? Ann Thorac Surg 62 :16 14 16 16 11 Suzuki K, Tomomi U, Soichi M, Shinji K, Kazuhiro S, Kimio F (19 97) Hazards of laparoscopic adrenalectomy in patients with adrenal malignancy J Urol 15 8:2227± 2229 12 Hobart MG, Gill IS, Schweizer D, Sung GT, Bravo EL (2000) Laparoscopic adrenalectomy for large-volume (³ 5 cm) adrenal masses J Endourol 14 :14 9 15 4 13 Luton... mainly to the surgical team's laparoscopic experience [4, 5] Limitations of laparoscopic resection in large, malignant lesions are related to the difficulties in developing a proper oncological surgical field, with an increased risk of intraoperative tumor injuries during surgical dissection Some authors [9 11 , 17 , 18 ] have reported a widespread dissemination of the disease following laparoscopic surgery. .. (2004) Laparoscopic radical adrenalectomy with adrenal vein tumor thrombectomy: technical considerations J Urol 17 1 :12 23 12 26 17 Ushiyama T, Suzuki K, Kageyama S, Fujita K, Oki Y, Yoshimi T (19 97) A case of Cushing's syndrome due to adrenocortical carcinoma with recurrence 19 months after laparoscopic adrenalectomy J Urol 15 7:2239±22 41 18 Deckers S, Derdelinckx L, Col V, Hamels J, Maiter D (19 99) Peritoneal... could result in prolonged, disease-free patient survival [10 ] Indications for laparoscopic adrenalectomy in metastatic lesions include: n Curative reasons, in solitary adrenal metastasis n Diagnostic purposes, in suspected adrenal metastasis Contraindications for transperitoneal laparoscopic adrenalectomy in malignancies can be divided into: contraindications to laparoscopy in general such as se- 4 G Guazzoni... in the disease; the adrenal mass frequently shows extracapsular invasion, an absolute contraindication to laparoscopic surgery Luton et al [13 ] reported that 79% of ACs are hyperfunctioning lesions and, according to Belldegrun et al [14 ], these are usually larger than 6 cm in size at diagnosis: in reviewing 11 4 ACs, 10 5 had a diameter of over 6 cm With increased lesion size, the possibility of having . Avenue Cleveland, OH 4 419 5 USA ISBN -1 0 3-5 4 0-2 0 51 2-8 Springer Berlin Heidelberg New York ISBN -1 3 97 8-3 -5 4 0-2 0 51 2-8 Springer Berlin Heidelberg New York Library of Congress Control Number: 200 411 6 515 A catalog. x0 y0 w1 h1" alt="" Laparoscopic Urologic Surgery in Malignancies Jean J.M. C. H. de la Rosette ´ Inderbir S. Gill Editors Laparoscopic Urologic Surgery in Malignancies With 17 8 Figures 12 Professor. Urology (G 4 -1 62) Meibergdreef 9 11 05 Amsterdam ZO The Netherlands Dr. Inderbir S. Gill Section of Laparoscopic and Minimally Invasive Surgery Glickman Urological Institute, A 10 0 Cleveland Clinic Foundation 9500