V14-11 SINGLE PORT SUPINE BILATERAL ADRENALECTOMY

You have accessJournal of UrologyAdrenal/Renal Oncology II (V14)1 May 2024V14-11 SINGLE PORT SUPINE BILATERAL ADRENALECTOMY Akhil A. Saji, Luis Medina, and Hooman Djaladat Akhil A. SajiAkhil A. Saji , Luis MedinaLuis Medina , and Hooman DjaladatHooman Djaladat View All Author Informationhttps://doi.org/10.1097/01.JU.0001008704.74547.03.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal cell carcinoma (RCC) is the third most diagnosed urologic cancer in the United States. An estimated one out of five patients diagnosed with RCC will develop disease recurrence in the adrenal glands during post-surgical surveillance. Disease specific factors such as tumor stage and grade, presence of vascular invasion, and tumor histology have been shown to affect adrenal recurrence rates. In this video, we demonstrate a minimally invasive technique for bilateral adrenalectomy using the da Vinci Single Port (SP) platform in the setting of bilateral adrenal RCC recurrence. METHODS: The patient is a 63-year-old male with a history of pT3a ISUP 2 clear cell RCC of the right kidney treated with radical nephrectomy. After 16 months without evidence of disease recurrence, the patient was noted to have new onset bilateral adrenal masses on surveillance cross sectional imaging. Biopsy confirmed clear cell RCC recurrence in both adrenal glands. Adjuvant lenvatinib and pembrolizumab immunotherapy were administered due to progression free survival (PFS) benefit demonstrated in the CLEAR trial. After completion of immunotherapy, the patient was counseled and consented to bilateral adrenalectomy using the SP robotic platform. RESULTS: Total operative time was 415 minutes with less than 250 mL of blood loss. The patient was discharged home on post-operative day two after appropriate steroid taper was completed and maintenance dose given. Pathology demonstrated metastatic clear cell RCC, ISUP 2 with negative margins. Zero 30-day complications were noted at time of follow-up visit. CONCLUSIONS: The SP robotic platform with its low profile and flexible positioning can allow surgeons to perform bilateral surgical procedures, such as adrenalectomy without the need for patient repositioning and removing the need for multiple peritoneal entry sites. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1230 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Akhil A. Saji More articles by this author Luis Medina More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement PDF downloadLoading ...