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Laparoscopic right adrenalectomy for Conn's adenoma using ultrasonic shears

D Mutter, MD, PhD, FACS J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Jan 2008;08(01). URL: http://websurg.com/doi/vd01en2229

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  • 2029
  • 105
  • 2008-01-15
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This video very clearly displays all the salient points of the performance of a right adrenalectomy with particular emphasis on the control of the vascular supply. After controlling the venous landmarks, the authors move to control the main arteries of the adrenal gland. The authors identify the medial and superior pedicles and completely dissect them, gaining control with a one-clip application. The medial pedicle is only 1cm from the aorta. Severe bleeding may ensue, so they control the superior pedicle originating from the diaphragmatic artery with a clip. Identifying these arteries allows the authors to perform a complete removal of the adrenal gland and its surrounding fat. They clearly identify the renal artery, the renal vein just above it, and the inferior pedicle, which is also controlled with a simple clip application. At this point, the gland can be completely mobilized medially and inferiorly.