The following is a summary of “A Novel Method of Tunneling Retroperitoneoscopic Adrenalectomy: A Prospective Study,” published in the April 2024 issue of Urology by Zhang et al.
Introducing an innovative surgical technique, the study presents the team’s extensive experience with the tunnel method in laparoscopic adrenalectomy. Over a period spanning from July 2019 to June 2022, researchers conducted 83 cases of “Tunnel Method Laparoscopic Adrenalectomy” in a prospective study. The cohort comprised 45 male and 38 female patients aged 25 to 73 years (mean: 44.6 years). Among these cases were 59 adrenal cortical adenomas, 9 pheochromocytomas, 6 cysts, 4 myelolipomas, 1 ganglioneuroma, and 4 instances of adrenal cortical hyperplasia. The tumors were danatomically distributed with 39 cases on the left 42 on the right and 2 bilateral cases. Utilizing ultrasound monitoring, percutaneous puncture was employed to mark the path to the target organ, enabling subsequent delineation and separation under direct view using a single-port, single-channel laparoscope. This facilitated the insertion of instruments through the affected adrenal gland, thereby creating adequate operational space for adrenalectomy.
All 83 surgeries were completed, with varying numbers of puncture holes used in each case (51 with one hole, 25 with two holes, and 7 with three holes). The mean operation time was 47 minutes, ranging from 31 to 105 minutes, accompanied by a mean blood loss of 40 mL, ranging from 10 to 220 mL. Notably, there were no conversions to open surgery or intraoperative complications. During postoperative follow-up spanning 6 to 28 months, comprehensive re-examinations using ultrasound, CT, and other imaging modalities revealed no recurrences or complications. The completion of the tunnel method laparoscopic adrenalectomy signifies a significant advancement, departing from the traditional approach of step-by-step retroperitoneal tissue separation.
This direct access to the target organ substantially reduces associated damage and complications, offering a novel avenue for minimally invasive retroperitoneal surgery and introducing innovative concepts to the field.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01484-x
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