Suprarrenalectomía endoscópica retroperitoneal posteriorbeneficios, desventajas, indicaciones, trucos y detalles técnicos

  1. Villar del Moral J. 1
  2. Fernández Segovia E. 1
  3. Ercoreca Tejada S. 1
  4. García Jiménez A. 1
  5. Herrero Torres M. Á. 1
  6. Santoyo Villalba J. 1
  7. González Martínez S. 2
  8. Arcelus Martínez J. I. 1
  9. Muñoz Pérez N. 1
  1. 1 Hospital Universitario Virgen de las Nieves. Granada.
  2. 2 Hospital General Nuestra Señora del Prado. Talavera de la Reina. Toledo.
Journal:
Cirugía Andaluza

ISSN: 2695-3811,  1130-3212

Year of publication: 2020

Volume: 31

Issue: 3

Pages: 287-293

Type: Article

DOI: 10.37351/2020313.10 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: Cirugía Andaluza

Abstract

In this review, we analyze the possible advantages and disadvantages of the posterior retroperitoneal endoscopic access for the treatment of adrenal lesions. Among the first, the reduction of operative time, the facilitation of partial adrenalectomy, the avoidance of adhesions and irradiated fields, the improvement of intraoperative haemostasis and postoperative patient comfort, and finally the reduction of the rate of incisional hernia. Among the latter, a limited workspace, a lack of clear anatomical references, and its inability to treat concomitant abdominal pathologies. On the other hand, its applicability is highly dependent on the anthropometric configuration of the patient and limited by obesity. Also, its usefulness is questioned in case of coexistence of certain renal pathologies, and well as for the treatment of malignant lesions. The specific contraindications of this approach will also be assessed. Finally, some technical details will be highlighted in relation to the positioning of the patient, port placement, dissection of the retroperitoneal space, identification and sealing of the adrenal vein, glandular excision, and extraction. The posterior retroperitoneal route is a safe, feasible, direct and effective approach to treat adrenal lesions. Correctly indicated, this technique obtains results at least as good as those achieved with the lateral transperitoneal laparoscopic approach. Therefore, it should be part of the armamentarium of the Endocrine Surgery Units caring for patients with adrenal disease.

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