METHOD FOR SELECTION OF POSITIONS FOR ENDOSCOPIC PORT IN LEFT-SIDED LAPAROSCOPIC ADRENALECTOMY

摘要

The method for selection of the positions for the endoscopic port in left-sided laparoscopic adrenalectomy comprises the delineation of the surgery area, the selection of the positions for the insertion of the instrument, and the trocar puncture of the cavity wall. In the normostenic patient, aged 12 and older, with tumor size less than 60 mm, the puncture is performed at a point on the midclavicular line 2 cm below the costal arch and the first port for the insertion of endoscope is installed for endoscope insertion. The second port is installed at a point on the middle clavicular line, 2 cm below the costal arch, the third - on the middle axillary line, 2 cm below the costal arch. Following mobilization of the spleen angle of the colon, the endoscope is transferred to the port located on the middle axillary line, while the first port is used for the insertion of the ultrasound scalpel. Depending on the size of the tumor, the corresponding points of the port location are displaced downwards by 2 cm (if tumor size is within 60-100 mm) or by 3 cm (if tumor size is within 100-150 mm).