Article Category: Brief communication
Published Online: Aug 31, 2017
Page range: 157 - 162
DOI: https://doi.org/10.5372/1905-7415.1102.545
Keywords
© 2017 Apirak Santingamkun, Kamol Panumatrassamee, Prakorn Kiatsopit
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Laparoscopic adrenalectomy remains a challenging operation for pheochromocytoma (PCC) because of excessive secretion of catecholamines causing hemodynamic instability.
Objectives
To evaluate the use of the LigaSure vessel sealing system (Covidien-Medtronic) to secure hemostasis during laparoscopic adrenalectomy for PCC.
Methods
In this observational study we retrospectively reviewed a case series of 19 patients with preoperatively diagnosed PCC, who underwent laparoscopic adrenalectomy who underwent laparoscopic adrenalectomy using the LigaSure vessel sealing instead of using vascular clips or suturing. We report intraoperative findings, conversion rates, blood loss, operative time, morbidity, and postoperative outcomes.
Results
Surgery was performed successfully for 18 patients. Surgery for the remaining 1 patient of the present case series was converted to open adrenalectomy because of surrounding tissue invasion. No mortality or major morbidity was observed. Estimated blood loss was a mean (range 20–300) 153 mL (excluding the loss in the patient whose surgery was converted to open adrenalectomy). The pathology showed 6 patients with potentially malignant PCC (Pheochromocytoma of the Adrenal Scaled Score (PASS) ≥ 4).
Conclusions
The LigaSure device appears to be safe and effective in laparoscopic adrenalectomy for PCC. This clipless approach can be used with acceptable outcomes.