Document Detail


Laparoscopic appreciation of the adrenal artery: fact or fiction?
MedLine Citation:
PMID:  16190830     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is well accepted that identification and control of the adrenal vein is a critical step in laparoscopic adrenalectomy. The surgical and anatomic literature propagates the notion of a dominant or multiple dominant adrenal arteries that should likewise be controlled during surgical extirpation. MATERIALS AND METHODS: We assessed the frequency of adrenal-artery identification and the need for formal ligation in an extensive series of laparoscopic adrenalectomies. RESULTS: In our experience, even using a magnified laparoscopic view, we found it possible to identify and necessary to formally ligate an adrenal artery in only 3 of 265 cases (1.1%). Further, in this series, only the inferior adrenal artery was ever seen definitively to require formal clip ligation, while a discrete middle or superior adrenal artery was almost never seen, and the vasculature in these areas could be controlled with electrocautery or ultrasonic energy alone during routine dissection. CONCLUSIONS: The need to search for and ligate the arterial supply during laparoscopic adrenalectomy is not as clinically significant as once thought, and formal control appears unnecessary unless the vessels are serendipitously encountered during the routine dissection.
Authors:
Andrew B Joel; Jonathan N Rubenstein; Shelley Arredondo; Maxwell V Meng; Quan-Yang Duh; Marshall L Stoller
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  19     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-29     Completed Date:  2006-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  793-6     Citation Subset:  IM    
Affiliation:
Department of Urology, University of California-San Francisco, CA 94143, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Glands / blood supply*
Adrenalectomy / methods*
Arteries / anatomy & histology,  surgery*
Blood Loss, Surgical
Dissection
Humans
Laparoscopy / methods*
Ligation
Veins / anatomy & histology,  surgery
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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