title: First report on sequential totally endoscopic thymomectomy and adrenalectomy using computer-enhanced telemanipulation.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is considered the standard method for removal of benign adrenal tumors, regardless of hormone activity. Minimally invasive surgery for thymomectomy aims at limited approaches, avoiding complete sternotomy or large thoracotomy.
  
  
  METHODS
  We report on a case in which totally endoscopic thymomectomy and adrenal gland resection were performed sequentially using a computer-enhanced telemanipulation system within 3 weeks.
  
  
  RESULTS
  Operating time was 4.5 h for totally endoscopic adrenalectomy and 1.5 h for totally endoscopic thymomectomy. The patient was transferred to the normal ward on the day of operation after either procedure and had an uneventful recovery. Pathology yielded no malignancy in both cases.
  
  
  CONCLUSIONS
  This report demonstrates the safety and feasibility of various totally endoscopic procedures performed sequentially.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Frankfurt, Theodor Stern Kai 7, 60590 Frankfurt, Germany. fawad@gmx.de
authors.forename: M F
authors.initials: MF
authors.lastname: Khan
authors.forename: J
authors.initials: J
authors.lastname: Binder
authors.forename: S
authors.initials: S
authors.lastname: Dogan
authors.forename: W
authors.initials: W
authors.lastname: Bentas
authors.forename: T
authors.initials: T
authors.lastname: Aybek
authors.forename: G
authors.initials: G
authors.lastname: Wimmer-Greinecker
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D012371:Robotics / Q000379:methods*; D012449:Safety; D025321:Surgery, Computer-Assisted / Q000379:methods*; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*; D013934:Thymectomy / Q000379:methods*; D013945:Thymoma / Q000601:surgery; D013953:Thymus Neoplasms / Q000601:surgery