title: Initial experience of transumbilical laparoendoscopic single-site surgery of partial adrenalectomy in patient with aldosterone-producing adenoma.
abstract: BACKGROUND
  Laparoscopic single-site surgery has recently emerged in the field of urology and this minimally-invasive surgery has resulted in a further reduction in morbidity compared with traditional laparoscopy. We present our initial experience with laparoendoscopic single-site surgery of partial adrenalectomy (LESS-PA) to treat aldosterone-producing adenomas.
  
  
  METHODS
  A 60-year-old woman was diagnosed with aldosterone-producing macroadenomas in the left adrenal and aldosterone-producing microadenomas in the right adrenal. A two-step operation was planned. The first step involved transumbilical LESS-PA for the left adrenal tumors. A multichannel port was inserted through the center of the umbilicus and the left adrenal gland was approached using bent instruments according to standard traditional laparoscopic procedures. The tumors were resected using an ultrasonic scalpel, and the resected site was coagulated using a vessel sealing instrument and then sealed with fibrin glue. Operative time was 123 minutes and blood loss was minimal. The patient was discharged from hospital within 72 hours. Her right adrenal microadenomas will be treated in the next several months.
  
  
  CONCLUSIONS
  Although our experience is limited, LESS-PA appears to be safe and feasible for treating aldosterone-producing adenomas. More cases and comparisons with the multiport technique are needed before drawing any definite conclusions concerning the technique.
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Yuge
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.forename: Masanori
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Takeda
authors.forename: Ayano
authors.initials: A
authors.lastname: Takeda
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Miyashita
authors.forename: Isao
authors.initials: I
authors.lastname: Kurihara
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Shibata
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
mesh_terms: D000236:Adenoma / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D000311:Adrenal Glands / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology / Q000628:therapy; D010535:Laparoscopy / Q000295:instrumentation*; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000379:methods* / Q000534:rehabilitation; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery