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

摘要

The method for selection of the positions for the endoscopic port in right-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 anterior axillary line, 2 cm below the costal arch, the third - on the middle axillary line, 2 cm below the costal arch, the fourth – on the median line on the border of the upper and middle thirds of the distance between the xiphoid process and the navel. 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).