Intravenous methylene blue as an aid to intraoperative localization and removal of the adrenal glands during laparoscopic adrenalectomy.
BACKGROUND
We hypothesized that intravenous methylene blue will facilitate adrenal gland identification and resection during laparoscopic adrenalectomy.


METHODS
Five mini-Hanford pigs were anesthetized and monitored per an approved Internal Review Board protocol. Timing of color changes in the adrenals was recorded after administering methylene blue at three different doses: 2.5 mg/kg, 5.0 mg/kg, and 7.5 mg/kg. The time required for laparoscopic adrenalectomy with and without methylene blue was recorded.


RESULTS
No color change occurred after the 2.5 mg/kg dose. For the 7.5 mg/kg versus the 5.0 mg/kg dose there was a more rapid bluish color change (mean time, 1.89 minutes versus 3.45 minutes; P = 0.03) and a longer duration of bluish color change (mean time, 12.20 minutes versus 6.19 minutes; P = 0.01). Laparoscopic adrenalectomy using methylene blue resulted in a 34.5% faster median resection time (10.13 minutes versus 15.47 minutes).


CONCLUSIONS
Methylene blue concentrates in the adrenal glands and facilitates identification and resection of the adrenal glands by a laparoscopic approach.
Obermeyer
Robert J
RJ
Division of General Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6550 Fannin, Suite 1661, Houston, TX 77030, USA.
Knauer
Eric M
EM
Millie
Michael P
MP
Ojeda
Herminio
H
Peters
Michael B
MB
Sweeney
John F
JF
D000311:Adrenal Glands / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000818:Animals; D007275:Injections, Intravenous; D010535:Laparoscopy; D008751:Methylene Blue / Q000008:administration & dosage; D013552:Swine; D013556:Swine, Miniature
D008751:Methylene Blue