Tag Archives: Adrenalectomy

PUBLISHED: Right Posterior Retroperitoneoscopic Adrenalectomy (PRA) for Adrenocortical Adenoma

Right Posterior Retroperitoneoscopic Adrenalectomy (PRA) for Adrenocortical Adenoma
Neeta Erinjeri, MD; Tobias Carling, MD, PhD, FACS
Yale School of Medicine

Posterior retroperitoneoscopic adrenalectomy (PRA) allows the surgeon to approach the adrenal gland through the back rather than the more traditional laparoscopic transabdominal adrenalectomy (LTA) approach. This technique was popularized in Germany but is being used increasingly throughout the United States. Smilow Cancer Hospital at Yale New Haven was one of the early adopters of this technique in the US, and Dr. Tobias Carling presents the operation here.

PUBLISHED: Bilateral Posterior Retroperitoneoscopic Adrenalectomy with Cortical Sparing on Right Side

Bilateral Posterior Retroperitoneoscopic Adrenalectomy with Cortical Sparing on Right Side
Yale School of Medicine

Taylor C Brown, MD, MHS
Yale School of Medicine

Tobias Carling, MD, PhD, FACS
Yale School of Medicine

Cortical-sparing adrenalectomy allows for the resection of adrenal tumors while preserving unaffected adrenal tissue to prevent adrenal insufficiency. This is especially important in patients with bilateral adrenal tumors, typically pheochromocytomas.

Posterior retroperitoneoscopic adrenalectomy (PRA) allows for a minimally invasive approach to adrenal gland resection compared with the more traditional laparoscopic transabdominal adrenalectomy and open approaches. This approach is ideal to address patients with bilateral disease and was used in this case of a 31-year-old female patient presenting with bilateral pheochromocytomas in the setting of multiple endocrine neoplasia 2A syndrome and coexisting medullary thyroid carcinoma of the right thyroid lobe. A close review of her imaging demonstrated normal-appearing adrenal cortex tissue on the right side that allowed for cortical-sparing adrenalectomy on that side.

PREPRINT RELEASE: Bilateral Retroperitoneoscopic Posterior Adrenalectomy with Cortical Sparing on Right Side


Bilateral Retroperitoneoscopic Posterior Adrenalectomy with Cortical Sparing on Right Side
Smilow Cancer Hospital at Yale New Haven

Tobias Carling, MD, PhD, FACS
Associate Professor of Surgery
Yale School of Medicine

Taylor C. Brown, MD, MHS
Fellow, Endocrine Surgery
Yale School of Medicine

In this case, Dr. Carling at the Smilow Cancer Hospital at Yale New Haven performs a bilateral retroperitoneoscopic posterior adrenalectomy with cortical sparing on the right side on a 31-year-old female with bilateral pheochromocytoma in the setting of MEN2.

PREPRINT RELEASE: Right Posterior Retroperitoneoscopic Adrenalectomy

Right Posterior Retroperitoneoscopic Adrenalectomy
Smilow Cancer Hospital at Yale New Haven

Tobias Carling, MD, PhD, FACS
Associate Professor of Surgery
Yale School of Medicine

One of the early adaptors of the approach, Tobias Carling, MD, PhD, FACS, performs a right posterior retroperitoneoscopic adrenalectomy on a patient that presented with subclinical Cushing's syndrome. Specifically, she had elevated urinary cortisol, failed a dexamethasone suppression test, and had a growing adrenal tumor as revealed by serial imaging. Due to the patient’s anatomy, Dr. Carling used a lateral approach to ligating the right adrenal vein; this video includes his usual medial approach as an additional module.

PREPRINT RELEASE: Laparoscopic Adrenalectomy

Laparoscopic Adrenalectomy
Massachusetts General Hospital
Richard Hodin, M.D.
Professor of Surgery, Harvard Medical School

After visiting an endocrinologist who diagnosed her with aldosteronism, the patient takes a CT scan that reveals a 8mm nodule in the left adrenal gland. Dr. Hodin performs a laparoscopic adrenalectomy to remove it.