The use of intraoperative ultrasound in laparoscopic adrenal surgery - TheSaint Vincent experience

Background: Laparoscopic adrenalectomy has been shown to be a safe and effe ctive therapy for benign adrenal lesions. We review our experience with thi s procedure, including the use of laparoscopic ultrasound. Methods: We retrospectively reviewed our experience with 36 patients who un derwent resection of 42 adrenal glands. Data gathered included preoperative evaluation and diagnosis, operative time, blood loss, complications, and f ollow-up status. Laparoscopic ultrasound was used to guide dissection and c haracterize a variety of adrenal lesions. Results: Thirty-five of 36 patients underwent successful laparoscopic adren alectomy. There was one conversion to the open procedure in a patient with bilateral adrenal metastases from an endometrial cancer. For the bilateral laparoscopic procedure, the operative time averaged 262 mins, blood loss wa s 160 cc, and hospital stay was 3.0 days. For unilateral cases, operative t ime averaged 193 min, blood loss was 108 cc, and hospitalization was 1.1 da ys. Six patients experienced perioperative complications, most of which wer e minor and transient. Laparoscopic ultrasound was useful to define anatomy and to identify the adrenal vein, especially on the left side. Conclusions: Laparoscopic adrenalectomy is the procedure of choice for beni gn adrenal disease. Laparoscopic ultrasound is useful to localize and aid i n the dissection of the left adrenal vein.