Navigation with the Use of Intraoperative Ultrasonography in Videoscopic Adrenal Surgery

• Authors: Jan Sopiński , Krzysztof Kuzdak
• Languages of publication: EN

Abstracts

EN

The aim of the study was to assess the efficacy of intraoperative ultrasonography during videoscopic adrenalectomy.Material and methods. The study was conducted in patients undergoing extraperitoneal videoscopic adrenalectomy for adrenal tumours in the Department of Endocrine, General and Vascular Surgery of the Medical University in Łódź in 2008-2011.Results. The active group consisted of 20 patients in whom navigation with the use of intraoperative ultrasonography (IOUS) was used in the course of surgery. The comparison group consisted of 46 patients operated without the use of IOUS. In the active group, we managed to obtain a shorter time of surgery by almost 20 min (89.44 ± 27.11 min vs 109.12 ± 33.88 min; p=0.034) and a shorter lesion access time by more than 15 min (28.61 ± 14.93 min vs 45.98 ± 20.44 min; p=0.002). Intraoperative blood loss was also significantly lower in the active group (86.11 ± 157 ml vs 169.27 ± 201.04 ml; p=0.037). In contrast, the use of IOUS did not affect the hospitalisation time (4.39 ± 3.27 days vs 3.83 ± 3.67 days; p=0.227), the rate of intraoperative complications (0/18 vs 2/41; p=1) and the conversion rate (2/20 - 10% vs 5/46 - 10.87%; p=1).Conclusions. 1. Intraoperative ultrasonography is useful for determining the tumour relationship with the surrounding anatomical structures. 2. Intraoperative ultrasonography is a useful technique in the assessment of adrenal tumour infiltration of the surrounding tissues. 3. This technique facilitates finding the pathological lesion, shortening the time of access to the tumour and procedure duration (thus reducing the burden for the patient). 4. Reduced blood loss was also obtained owing to the use of IOUS.

Keywords

EN

intraoperative ultrasonography (IOUS); videoscopic adrenalectomy

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 8
• Pages: 399-405

Dates

published

1 - 8 - 2012

online

17 - 9 - 2012

Contributors

author

Jan Sopiński

• Clinic of Endocrine, General and Vascular Surgery, Medical University in Łódź

author

Krzysztof Kuzdak

• Clinic of Endocrine, General and Vascular Surgery, Medical University in Łódź

References

• Luck AJ, Maddern GJ: Intraoperative abdominal ultrasonography. Br J Surg 1999; 86: 5-16.
• Schmidt G: Ultrasonografia. Medipage, Warszawa 2008.
• Major P, Pędziwiatr M, Matłok M et al.: Cystic adrenal lesions - analysis of indications and results of treatment. Pol Przegl Chir 2012; 84, 4: 184-89.
• Gagner M, Lacroix A, Bolte E: Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma. N Engl J Med 1992; 327: 1033.
• Kostewicz W: Chirurgia laparoskopowa. PZWL, Warszawa 2002.
• Szmidt J, Kużdżał J: Podstawy chirurgii. Medycyna Praktyczna, Kraków 2010.
• Vargas H, Kavoussi L, Bartlett D et al.: Laparoscopic adrenalectomy: a new standard of care. Urology 1997; 49: 673-678.
• Pro Focus 2202. Podręcznik użytkownika.
• Brunt LM, Doherty GM, Norton JA et al.: Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. J Am Coll Surg 1996; 183: 1-10.
• Duh QY, Siperstein AE, Clark OH et al.: Laparoscopic adrenalectomy. Arch Surg 1996; 131: 870-76.
• Prinz R: A comparison of laparoscopic and open adrenalectomies. Arch Surg 1995; 130: 489-94.
• Prinz RA: Lapaproscopic adrenalectomy. J Am Coll Surg 1996; 183: 71-73.
• Todd Heniford B, Iannniti D, Hale J et al.: The role of intraoperative ultrasonography during laparoscopic adrenalectomy. Surgery 1997; 122: 1068-74.
• Cheng S, Saunders B, Gauger P et al.: Laparoscopic partial adrenalectomy for bilateral pheochromocytomas. Ann Surg Oncol 2008; 15: 2506-08.[WoS]
• Kaouk J, Matin S, Bravo E et al.: Laparoscopic bilateral partial adrenalectomy for pheochromocytoma. Urology 2002; 60: 1100-03.
• Pautlr S, Choyke P, Pavlovich C et al.: Intraoperative ultrasound aids in dissection during laparoscopic partial adrenalectomy. J Urol 2002; 168: 1352-55.
• Bendinelli C, Lucchi M, Buccianti P et al.: Adrenal masses in non-small cell lung carcinoma patients: is there any role for laparoscopic procedures. Journal of laparoendoscopic & advanced surgical techniques. 1998; 8(3): 119-24.
• Boris R, Gupta G, Linehan W et al.: Robot-assisted laparoscopic partial adrenalectomy: initial experience. Urology 2011; 77: 775-80.
• Vaughn Z, Johnson F, Beretvas R: Laparoscopic adrenalectomy for Conn's syndrome complicated by ipsilateral congenital pelvic kidney. Surg Endosc 2004; Vol. 18(10): 1539.
• Disick G, Palese M: Extra-adrenal pheochromocytoma: diagnosis and management. Curr Urol Rep 2007; 8(1): 83-88.[PubMed][Crossref]
• Lucas S, Spitz J, Arregui M: The use of intraoperative ultrasound in laparoscopic adrenal surgery. Surg Endosc 1999; 13: 1093-98.

Identifiers

DOI

10.2478/v10035-012-0067-3