title: Innovative approach to laparoscopic adrenalectomy for treatment of unilateral adrenal gland tumors in dogs.
abstract: OBJECTIVE
  To report a technique for, and short-term outcome of unilateral laparoscopic adrenalectomy in dogs positioned in sternal recumbency without abdominal support.
  
  
  METHODS
  Experimental and prospective clinical study.
  
  
  METHODS
  Healthy dogs (n = 5) and dogs with unilateral adrenal gland tumor (n = 9).
  
  
  METHODS
  Anesthetized dogs were positioned in sternal recumbency with 2 cushions placed under the dog to elevate the chest and pelvic area so that the abdomen was not in contact with the surgical table allowing gravitational displacement of the abdominal viscera. Three 5-mm portals were located in the paralumbar fossa. Adrenal glands were carefully dissected and surrounding tissues sealed and cut using a vessel-sealing device. A retrieval bag or part of a surgical glove finger was used to remove the adrenal gland from the abdomen. Surgical time and complications were recorded, and short-term outcome assessed.
  
  
  RESULTS
  Adrenal glands in normal dogs and unilateral adrenal tumors (8 left, 1 right) not involving the caudal vena cava in affected dogs were successfully removed laparoscopically. There were no major intraoperative complications. Of the dogs with adrenal tumors, 1 dog died within 24 hours of surgery from unrelated causes. Eight dogs recovered within 1 day and were discharged within 72 hours. Surgical times ranged from 42 to 117 minutes and were significantly shorter than those reported previously.
  
  
  CONCLUSIONS
  Positioning anesthetized dogs in sternal recumbency with the abdomen suspended to facilitate gravitational displacement of the abdominal viscera improves access to, and visibility of, the adrenal gland for laparoscopic removal.
authors.affiliation: Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands. elainenaan@me.com
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Naan
authors.forename: Jolle
authors.initials: J
authors.lastname: Kirpensteijn
authors.forename: Gilles P
authors.initials: GP
authors.lastname: Dupré
authors.forename: Sara
authors.initials: S
authors.lastname: Galac
authors.forename: MaryAnn G
authors.initials: MG
authors.lastname: Radlinsky
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery / Q000662:veterinary*; D000315:Adrenalectomy / Q000379:methods / Q000662:veterinary*; D000818:Animals; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary*; D008297:Male; D010865:Pilot Projects