Long KL*, Graham PH, Grubbs EG, Lee JE and Perrier ND
Department of Surgical Endocrinology, University of Texas MD Anderson Cancer Center, USAFulltext PDF
A 53-year old male was diagnosed with bilateral pheochromocytomas after abdominal imaging revealed bilateral adrenal masses. Elevated serum catecholamines confirmed a pheochromocytoma, MIBG scan identified bilateral isotope uptake and genetic testing revealed a TMEM 127 mutation. Antihypertensive catecholamine-blocking medication was initiated. Given the desire to retain adequate cortical function, selective resection with a left total adrenalectomy and a cortical-sparing right sided adrenalectomy was planned via a retroperitoneoscopic approach. Intraoperatively, fluorescent indocyanine green was utilized to confirm perfusion to the right-sided adrenal remnant prior to proceeding with a left-sided total resection. This case exemplifies a method of intraoperative confirmation of cortex perfusion that enhances laparoscopic cortical-sparing adrenalectomy.
Adrenal; Retroperitoneoscopic; Indocyanine green; Cortical-Sparing
Long KL, Graham PH, Grubbs EG, Lee JE, Perrier ND. Intraoperative use of Indocyanine Green to Confirm Perfusion of Remnant Tissue in Cortical-Sparing Retroperitoneoscopic Adrenalectomy. Clin Surg. 2016; 1: 1111.