경복막 접근법을 통한 단일 통로 복강경 부신 절제술의 초기 경험

Initial Experience of Single Port Transperitoneal Laparoscopic Adrenalectomy

Purpose: Single port laparoscopic surgery is an area of active investigation in abdominal surgery. A standard procedure for single port laparoscopic adrenal surgery has not been established. We retrospectively investigated intraoperative and postoperative outcomes following laparoscopic adrenalectomy via mono-port (LAMP). Methods: Between March 2009 and December 2009,10 patients underwent LAMP at Kangbuk Samsung Hospital. The same surgeon performed all surgeries. The first 5 cases underwent LAMP using an Alexis Wound Retractor (Applied Medical, Rancho Santa Margarita, CA, USA) with surgical gloves, and others were done with an OCTO Port (Dalim Surgnet, Korea). Results: Of the 10 patients, 5 were male and 5 were female. The mean age was 43.7&#177;9.9 years (range, 34&#8764;62), and the mean BMI was 24.1&#177;4.0 kg/m<SUP>2</SUP> (Range, 17.1&#8764;30.0). The mean tumor size was 32.5&#177;16.9 mm (range, 12&#8764;60),mean operative time was 127.0&#177;29.5 min (range, 90&#8764;180), and mean hospital stay was 4.5 days (range, 3&#8764;7). Three patients were diagnosed with non-functioning cortical adenoma, 3 with Cushing's syndrome, 2 patients with pheochromocytoma, and others with primarily hyperaldosteronism and myelolipoma. Major postoperative morbidity, blood transfusions, or conversion to open surgery did not occur. Conclusion: The outcome of LAMP demonstrates the safety and feasibility of this procedure. With increasing surgeon experience and refinement in instrument technology, we believe LAMP is likely to become a standard approach to adrenal disease. (Korean J Endocrine Surg 2011;11:283-286)