LAPAROSCOPIC EXCISION OF RETROCAVAL PARAGANGLIOMA
J. B. Mendes1, M. T. Tanaka1, O. E. H. Fugita2, P. R. Kawano2, F. Mayer2, S. C. Abreu2, G.N. Fonseca2, E. F. Carvalhal2, T. M. Siqueira Jr 2
1Master Clínica, Cascavel, Brazil, 2Urolap, São Paulo, Brazil
Introduction: The adrenalectomy was the first urologic surgery to recognize the laparoscopic approach as a gold-standard technique, no matter if it is trans or extraperitoneally, or treating benign or malignant disease.
Objective: To demonstrate the laparoscopic technique of a right retrocaval paraganglioma excision.
Method: A 48-year-old female patient underwent a transperitoneal laparoscopic excision of the aforementioned retroperitoneal lesion. Due to a lumbar pain, a 4.5 x 4.2 x 3.7 cm peri adrenal mass, projecting itself to the retrocaval region, was detected on CT scans. No hormone or cathecolamine production were evident. The patient position was the classical one for laparoscopic adrenalectomy, with four port-sites. Only monopolar electrocautery and clips were used for blood vessels control. The right renal vein and the posterior-lateral aspect of the inferior vena cava had to be dissected in order to control the multiple small pedicles supplying the referred mass.
Result: The surgery was uneventful, no hemodynamic instability occurred with a total of 180 minutes. The patient was discharged 48 hours after the surgery and the pathological diagnose was an extradrenal pheochromocytoma.
Conclusion: The laparoscopic excision of a paraganglioma may be accomplished even in an unfavorable location as the retrocaval region.