Right Posterior Retroperitoneoscopic Adrenalectomy (PRA) for Adrenocortical Adenoma

1. Introduction

2. Surgical Approach

1. Patient positioning
2. Mark Incisions

3. Access and Placement of Ports

1. Incisions
2. Placement of Ports

4. Adrenal Gland Exposure

1. Development of Retroperitoneal Space
2. Mobilization of Superior Pole of Right Kidney

5. Adrenal Gland Dissection

1. Mobilization of Plane Towards Liver
2. IVC Exposure
3. Approach Adrenal Vein Medially
4. Approach Adrenal Vein Laterally if Necessary
5. Adrenal Vein Ligation

6. Specimen Extraction via Endo Catch

7. Hemostasis and Inspection

8. Successful Medial Approach to and Ligation of Adrenal Vein

9. Closure

1. Port Site Hemostasis
2. Suture Deep Layer
3. Injection of Lidocaine
4. Suture Superficial Layer
5. Dressing

10. Post-op Remarks