부신 질환에 대한 외과적 치료의 최근 경향
Recent Trends in Surgical Management of Adrenal Diseases
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Laparoscopic adrenalectomy (LA) has become the standard for the management of benign adrenal tumors since Gagner reported a successful surgery in 1992. Conventional open adrenalectomies have been replaced by LA because of significant advantages such as reduced wound pain and hospital stays, decreased transfusion requirements, and postoperative complications. In addition to the development of laparoscopic surgery, robot-assisted adrenalectomies are gaining popularity worldwide. The robotic system offers several advantages: it magnifies a surgeon’s view with 3D optics, offers excellent resolution and depth perception, and the robotic wrists offer 7 degrees of freedom, allowing for precise movements. Another new technique of laparoscopic adrenal surgery is single-port surgery, which is an effort to reduce the number of trocars and their related wound complications. Although this is technically more difficult compared to conventional laparoscopic surgeries, patients are satisfied with a single-site scar and reduced pain. In this paper, the recent development of new techniques in adrenal surgery are introduced and their specific advantages and disadvantages are discussed. Also, this article reviews the clinical results of a partial adrenalectomy for small benign adrenal tumors and adrenalectomies for single adrenal metastasis from extra-adrenal malignancy. (Korean J Endocrine Surg 2011;11:229-233)
Abstract
Laparoscopic adrenalectomy (LA) has become the standard for the management of benign adrenal tumors since Gagner reported a successful surgery in 1992. Conventional open adrenalectomies have been replaced by LA because of significant advantages such as reduced wound pain and hospital stays, decreased transfusion requirements, and postoperative complications. In addition to the development of laparoscopic surgery, robot-assisted adrenalectomies are gaining popularity worldwide. The robotic system offers several advantages: it magnifies a surgeon’s view with 3D optics, offers excellent resolution and depth perception, and the robotic wrists offer 7 degrees of freedom, allowing for precise movements. Another new technique of laparoscopic adrenal surgery is single-port surgery, which is an effort to reduce the number of trocars and their related wound complications. Although this is technically more difficult compared to conventional laparoscopic surgeries, patients are satisfied with a single-site scar and reduced pain. In this paper, the recent development of new techniques in adrenal surgery are introduced and their specific advantages and disadvantages are discussed. Also, this article reviews the clinical results of a partial adrenalectomy for small benign adrenal tumors and adrenalectomies for single adrenal metastasis from extra-adrenal malignancy. (Korean J Endocrine Surg 2011;11:229-233)
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