ADRENALECTOMIA LAPAROSCÓPICA TRANSPERITONEAL
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![Anatomia ,[object Object],[object Object],[object Object]](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-3-2048.jpg?cb=1668584759)
![vascularização arterial ,[object Object],As faces anterior, posterior e inferolateral são pouco vascularizadas](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-4-2048.jpg?cb=1668584759)
![Adrenal: vascularização venosa ,[object Object],[object Object]](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-6-2048.jpg?cb=1668584759)
![Fisiologia ,[object Object],[object Object],Medula: nor e adrenalina](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-8-2048.jpg?cb=1668584759)
![Diagnóstico ,[object Object],[object Object],[object Object],[object Object]](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-9-2048.jpg?cb=1668584759)
![PRINCIPAIS INCIDENTALOMAS DA SUPRA-RENAL ,[object Object],PATOLOGIA FREQÜÊNCIA % Adenoma cortical 70 - 94 Adenocarcinoma cortical 0 – 25 Feocromocitoma 0 – 11 Cistos 4 - 22 Mielolipoma 7 – 15 Metástases 0 – 73 Outros (pseudocistos, granulomas, lipomas, hamartomas) 0 - 10](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-18-2048.jpg?cb=1668584759)
![ESTUDOS DE IMAGENS ,[object Object],[object Object],[object Object],[object Object],[object Object],Resnek RH, Armstrong P. imaging in endocrinology. The adrenal gland. Clin Endocrinol (Oxf), 40: 561, 1994. Korobkin M, Brodeur FJ, Francis IR et al. Delayed enhanced CT for differentiation of benign from malignant adrenal masses radiology, 200: 737, 1996](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-19-2048.jpg?cb=1668584759)
![ESTUDO DE IMAGENS ,[object Object],[object Object],[object Object],[object Object],[object Object],Resnek RH, Armstrong P. imaging in endocrinology. The adrenal gland. Clin Endocrinol (Oxf), 40: 561, 1994. Korobkin M, Brodeur Fj, Francis IR et al. Delayed enhanced CT for differentiation of benign from malignant adrenal masses radiology, 200: 737, 1996](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-20-2048.jpg?cb=1668584759)
![ESTUDOS RADIOISOTÓPICOS ,[object Object],[object Object],[object Object],Resnek RH, Armstrong P. imaging in endocrinology. The adrenal gland. Clin Endocrinol (Oxf), 40: 561, 1994. Korobkin M, Brodeur FJ, Francis IR et al. Delayed enhanced CT for differentiation of benign from malignant adrenal masses radiology, 200: 737, 1996 FEOCROMOCITOMAS](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-21-2048.jpg?cb=1668584759)
![TUMORES SUPRA-RENAIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lucon AM, Latronico AC. Doenças benignas e malignas das supra-renais. In: Barata HS, Carvalhal GF. Urologia - Princípios e Prática. Pp. 581-7, ed. ArtMed. 1999](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-22-2048.jpg?cb=1668584759)
![FEOCROMOCITOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goldstein RE, et al. Clinical Experience Over 48 years with feocromocytoma Ann surg 1999; 229(6) 755-764](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-23-2048.jpg?cb=1668584759)
![TUMORES METASTÁTICOS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lucon AM, Latronico AC. Doenças benignas e malignas das supra-renais. In: Barata HS, Carvalhal GF. Urologia - Princípios e Prática. Pp. 581-7, ed. ArtMed. 1999](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-24-2048.jpg?cb=1668584759)
![INCIDENTALOMA DE ADRENAL ,[object Object],[object Object],[object Object],[object Object],[object Object]](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-25-2048.jpg?cb=1668584759)
![CIRÚRGIAS POR VÍDEO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-26-2048.jpg?cb=1668584759)
![INSTRUMENTOS NECESSÁRIOS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-27-2048.jpg?cb=1668584759)
![COMPLICAÇÕES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Brunt LM - The Positive Impact of Laparoscopic on complications of adrenal surg. Endos. 2002; 16(2) 252-257](https://image.slidesharecdn.com/adrenalectomialaparoscopicaguilherme-110318150207-phpapp02/75/adrenalectomia-laparoscpica-transperitoneal-33-2048.jpg?cb=1668584759)
ADRENALECTOMIA LAPAROSCÓPICA TRANSPERITONEAL
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TUMORES DA GLÂNDULA SUPRA RENAL
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ADRENALECTOMIA LAPAROSCÓPICA TRANSPERITONEAL
- 1. TUMORES DA GLÂNDULA SUPRA RENAL ADRENALECTOMIA LAPAROSCÓPICA TRANSPERITONEAL Dr. Guilherme Camarcio Neiva Urologista
- 7. Drenagem venosa Esquerda Direita
- 11. Mielolipoma
- 12. Hemorragia da supra renal
- 13. Feocromocitoma
- 14. Linfoma
- 28. POSIÇÃO DE TROCATERES TRANSPERITONEAL
- 29. ADRENALECTOMIA TRANSPERITONEAL ACESSO / PREPARAÇÃO DIREITA
- 30. ADRENALECTOMIA TRANSPERITONEAL ACESSO / PREPARAÇÃO ESQUERDA
- 31. RESULTADOS DE TRABALHOS PUBLICADOS COM MAIS DE 20 CASOS DE ADRENALECTOMIA LAPAROSCÓPICA Mirandolino e Colaboradores, Adrenalectomia Laparoscópica - Videocirurgia em Urologia – Técnicas e Resultados, Ed. Roca - 2007 Estudos Pacientes (nº) Tempo operatório (min) Taxa de conversão (%) Complicações (%) Internação (dias) Bendinelli Brunt Castilho Duh Filliponi Gagner Gill Henry Mancini Miccoli Rutherford Smith Terachi Thompson Vargas 60 24 94 23 50 88 110 50 172 25 67 28 100 50 20 96 183 117 226 - 123 188,6 147 132 109 123 152 240 167 155 1,6 0 5,1 0 0 3 - 8 7 0 - 3,5 3 12 10 6 - 21,3 4 0 12 19 8 8,7 - 4,5 3,5 15 6 10 3,4 3,2 6,1 2,2 2,5 2,4 1,9 5 5,8 3 5,1 2,3 7,2 3,1 3,2
- 32. RESULTADOS DE PUBLICAÇÕES RECENTES DE ADRENALECTOMIA LAPAROSCÓPICA Stephen Y. Nakada, Essential Urologic Laparoscopy, Ed. Humana Press - 2003 Autores Cirurgias Numero de pacientes Abordagem cirúrgica Tempo (min) Complicações (%) Mortalidade (%) Conversão (%) Guazzoni et al. 2001 Henry et al. 2000 Porpiglia et al. 2001 Valeri et al. 2001 Lezoche et al. 2000 Terachi et al. 2000 Terachi et al. 2001 Saloman et al. 2001 Bonjer et al. 2000 161 169 72 78 108 311 59 115 111 Trans Trans Trans Trans Trans Trans Retro Retro Retro 160 129 130 94-120 NR NR NR 118 114 2,8 7,5 16 2,6 2,8 8 12 15,5 11 0 0 0 1,3 0,9 0 0 0 0,9 Nr 5,0 4,0 2,6 0,9 3,2 5,1 0,8 5,0
- 34. OBRIGADO !