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LAPAROSCOPIC RIGHT ADRENALECTOMY Dr. Steve Eubanks, Director of the Duke - US Surgical Endosurgery Center at Duke University Medical Center is presenting a case of laparoscopic right adrenalectomy. Laparoscopic adrenalectomy is currently indicated in patients suffering from functional adrenal tumors such as aldosteronoma, Cushing's syndrome or pheochromocytoma. Also patients with non-functioning cortical adenoma up to 5 or 6 cm or adrenal metastasis are candidates to undergo this procedure. Laparoscopic adrenalectomy should not be offered to patients diagnosed with an adrenocortical carcinoma, malignant pheochromocytoma, large adrenal masses (>8cm) or to patients known to have any contraindications for laparoscopic surgery. YOUR TEXT HERE YOUR TEXT HERE YOUR TEXT HERE The operation starts by retracting the liver upwards while the dissection is carried out with the intent of separating the colon (hepatic flexure) off the abdominal wall down exposing the Gerota capsule, the duodenum and the inferior vena cava. The dissection is started on the inferior pole of the adrenal gland and directed in the superior and lateral direction. The operator uses a grasper to identify the upper pole of the kidney (lower pole of the adrenal gland). The medial border of the adrenal gland has been dissected exposing the inferior vena cava and the main adrenal vein. . This is usually done by employing the ultrasonic disector. Dissection around the vein is accomplished with a right angle clamp. The vein is controlled with silk ligatures passed around the vein with the right angle clamp and tied extra corporeally Ater the vein is tied with silk sutures, staples are applied to re-inforce the hemostasis. Once the main vein is taken, the dissection is continued up the medial border The adrenal gland is placed into a plastic retrieval bag. In this way the specimen is kept intact while removing it via the 12 mm port . The gland is retrieved under control vision in order to avoid spillage. Laparoscopy.com would like to thank Dr. Steve Eubanks, MD, FACS from the Duke - US Surgical Endosurgery Center for his video contribution.