Introduction: Solitary adrenal glands, bilateral adrenal tumors or hereditary syndromes are indications of partial adrenalectomy to avoid the need for lifelong corticosteroid replacement. Laparoscopic partial adrenalectomy (LPA) is a safe and effective method in order to provide complete removal of small adrenal lesions, as well as preservation of normal glandular parenchyma. Our objective is to describe a LPA using a linear stapling device in a hereditary pheochromocytoma.
Methods: We present the case of a 29-year-old male with hypertension, anxiety and heart palpitations due to pheochromocytoma caused by multiple endocrine neoplasia type 2B. Urinary catecholamine levels were four times higher than normal. CT scan revealed a 33 mm hypermetabolic right adrenal mass. Transperitoneal LPA was performed with the patient in left lateral decubitus. Four trocars were placed as the described technique parallel to the costal line. Right adrenal tumor was resected using a vascular linear stapling device. To preserve the blood supply of the remnant adrenal gland, it was not extensively dissected and the main adrenal vein was totally preserved.
Results: The patient had uneventful postoperative recovery. Surgical time was 90 minutes. Patient was discharged on the 2nd day. Pathology confirmed a 3.5 cm benign composite pheochromocytoma-ganglioneuroma with negative surgical margins. After surgery the patient achieved a complete clinical and biochemical response. During a follow-up of 6 months, no biochemical or radiological recurrence was observed.
Conclusions: LPA using a linear stapling device is a valid alternative to total adrenalectomy when normal adrenal tissue has to be preserved.