The development of the suprarenal gland - Surgical and anatomical considerations

Background. Aim of this research is to study the situation and relationship s of the adrenal gland in the first stage of development in order to give s ome contributes for the application of laparoscopic adrenalectomy; in the m eantime we describe the series of the debat changes occurring in the consti tution of the cortex and medulla, Methods. Analysis of histologic slices of thoraco-abdominal and abdominal r egions of human embryos and fetuses ranging from the fifth (12 mm CR) to th e twentieth week (170 mm CR). Results. At 12 mm CR an unique type of cells is present in the cortex; at 1 6 mm CR there are two different groups of cells. Sympathogonia enter into t he cortex at 16 mm CR, The right adrenal gland seems enclosed into the live r and a ligament containing the middle adrenal vein reaches the vena cava i nferior sulcus, The left adrenal gland, through the coelomic cavity, is in relationship with the stomach, the medial border of the spleen and the panc reatic body contained in the primitive dorsal mesogastrium. Conclusions, The timing of penetration of the gangliar cells into the corte x Is defined as well as the hypothesis that the matrix of the fetal and def initive cortex is the same: moreover the study of the early development all ows to understand the main characteristics of both the adrenal glands which are significant for a rational and differential laparoscopic approach.