A PORCINE MODEL FOR LAPAROSCOPIC ADRENALECTOMY

Laparoscopic adrenalectomy has been successfully performed and describ ed in humans. Though it is presently not widely employed it offers tre mendous potential for adrenal surgery. It remains, however, an advance d technique requiring demonstration and practice. The aim of this stud y is to develop a porcine model of adrenalectomy for teaching and adva ncing the technique applicable to human surgery. Five female pigs weig hing 10-20 kg underwent bilateral adrenalectomy by the lateral approac h using endotracheal intubation. The left adrenal was resected with th e pig in the right decubitus position. The animal was repositioned to left decubitus and the right adrenal was resected. In each case four 1 0-mm trochars were placed over the respective flanks. There was no nee d to mobilize the colon or liver (in the pig model). The peritoneum ov er each gland was incised and the gland dissected in a cephalocaudal m anner. The vessels were ligated and divided particularly those from th e vena cava. Upon completion blood loss (<100 cc) and operating times (mean 60 min for the left and 90 min for the right) were assessed and the animal was sacrificed. The glands were weighed (mean 1.23 g R and 1.15 g L) and measured. Using this model, experience is gained in posi tioning the subject as well as trocars, in fine dissection in a latera l orientation, and in techniques of hemostasis. Although porcine and h uman adrenal anatomy differ in some details the pig constitutes an exc ellent model for the development of the technical experience required to perform adrenalectomy in humans.