Two-Port Laparoscopic Adrenalectomy in Dogs

SIMPLE SUMMARY: An adrenal mass represents the primary indication for adrenalectomy. Laparoscopic adrenalectomy is a minimally invasive surgical technique that minimizes pain and improves patient recovery. The traditional technique involves the use of a single or multiple port (three or four). The objective of the study was to evaluate the feasibility and complication rate of two-port laparoscopic adrenalectomy to remove adrenal masses smaller than 4 cm in diameter. In total, 16 dogs with adrenal masses were enrolled in the study and clinicopathologic data were harvested from the medical records. The dogs were placed in sternal recumbency with cushions positioned under the sternum and pubis to simulate the quadrupedal station and displace the abdominal viscera. In all cases, the procedures were feasible with two ports. In five cases, capsule rupture occurred, and all were adrenal gland carcinomas. ABSTRACT: The gold-standard treatment for functional tumors is adrenalectomy, and the procedure can be either open or laparoscopic. Laparoscopic adrenalectomy (LA) is a minimally invasive technique designated for small–medium-sized adrenal tumors without vascular invasion. LA is routinely performed using three or four ports with the patient in sternal or lateral recumbency. The aim of the study was to evaluate the feasibility of LA with two ports in order to reduce invasiveness and improve patient recovery. In total, 16 dogs with adrenal tumors were included in the study and the two-port technique was performed. Adrenalectomy was performed based on the presence of hypercortisolism in thirteen cases, whereas, in three cases, adrenalectomy was performed in the absence of evidence of cortisol production. Thirteen cases were carcinomas and three were adenomas of the adrenal gland; furthermore, twelve were on the left side and four were on the right side. Capsule rupture occurred in five cases. After performing the technique in all cases, no additional ports or laparotomy conversion occurred. Based on the authors’ experience, laparoscopic adrenalectomy can be performed with two ports.