METHOD OF RETROPERITONEAL POSTERIOR ENDOSCOPIC ADRENALECTOMY OF LARGE TUMORS Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine, surgery.

SUBSTANCE: invention can be used in retroperitoneal posterior endoscopic adrenalectomy of large tumors. The patient is placed on the stomach with the hips and knees bent. A 1.5 cm long transverse incision is made under the end of the 12th rib, with the help of the index finger a tunnel is made deep into the retroperitoneal space, a 0.5 cm incision is made under the control of the finger under the end of the 11th rib and a lateral trocar with a diameter of 5 mm is installed, so that the end of the trocar rests against the distal phalanx of the finger, the finger is removed. A balloon-type trocar with a diameter of 12 mm is placed in the first incision, sealed with a syringe, pressure is created in the retroperitoneal space while maintaining CO2 of 20–25 mm Hg using an insufflator and an optical camera is introduced into this trocar. Then, in a 1 cm incision between the spinal column and the first trocar, a medial trocar with a diameter of 10 mm is placed at an angle of 45° into which a manipulator is inserted to mobilize the adrenal gland. An electrolytic Covidien Ligasure instrument is placed in the 5 mm lateral trocar, Gerota's fasciae are opened, and the adrenal vein is coagulated. For left-sided retroperitoneoscopic adrenalectomy, using the Covidien ligasure electrocautery instrument, the left adrenal gland is isolated under the diaphragm, lowered medially, the adrenal vein is found, which is coagulated, mobilizing the lower part of the adrenal gland with the tumor, moving away from the kidney.

EFFECT: method allows to reduce intraoperative blood loss, reduce the level of conversion, ensure the prevention of postoperative complications and reduce the rehabilitation period due to the combination of techniques of the claimed invention.

1 cl, 6 dwg, 2 ex