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Laparoscopic Robotic-assisted Excision of Adrenal Pheochromocytoma
CUA Online Library. Miller V. 06/22/13; 31389; UP-10
Ms. Vicki Miller
Ms. Vicki Miller
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Abstract
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Laparoscopic Robotic Assisted Excision of Adrenal Pheochromocytoma

Vicki Miller, PA-C; Eric Stockall, M.D.
(Presented by: Vicki Miller, PA-C)

Introduction and Objectives:
Historically pheochromocytoma excision has proven to be challenging for a variety of reasons such as blood pressure spikes and blood loss. With the development of sophisticated robotic systems, this surgery has become more feasible. The following will present a case highlighting the excision of a metabolically active pheochromocytoma using the DaVinci robot. A 79 year old male presented for evaluation of left adrendal mass measuring 8.0 cm. Subsequent testing revealed pheochromocytoma.

Methods:
Preoperatively the patient received a two week alpha blockade. The DaVinci robot was side docked with left side elevated. It was noted that manipulation of the tumor resulted in a spike of the patient’s blood pressure. Patient was noted to have large accessory veins, controlled with 45mm Ethicon endoscopic vascular stapler. Following occlusion of the veins there was a noted drop in blood pressure, typical of metabolically active pheochromocytoma. Blood loss was estimated at 200cc. Procedure was tolerated well.

Results:
Pheochromocytoma was successfully removed assistance from the DaVinci Robot. Blood loss and complications were minimal. Patient developed post operative ileus and was discharged home on post operative day 16.

Conclusion:
Robotic assistance allowed for limited manipulation of the lesion, reducing the risk of unsafe blood pressure spikes. Blood loss was minimized with the use of the Ethicon endoscopic vascular stapler.
Laparoscopic Robotic Assisted Excision of Adrenal Pheochromocytoma

Vicki Miller, PA-C; Eric Stockall, M.D.
(Presented by: Vicki Miller, PA-C)

Introduction and Objectives:
Historically pheochromocytoma excision has proven to be challenging for a variety of reasons such as blood pressure spikes and blood loss. With the development of sophisticated robotic systems, this surgery has become more feasible. The following will present a case highlighting the excision of a metabolically active pheochromocytoma using the DaVinci robot. A 79 year old male presented for evaluation of left adrendal mass measuring 8.0 cm. Subsequent testing revealed pheochromocytoma.

Methods:
Preoperatively the patient received a two week alpha blockade. The DaVinci robot was side docked with left side elevated. It was noted that manipulation of the tumor resulted in a spike of the patient’s blood pressure. Patient was noted to have large accessory veins, controlled with 45mm Ethicon endoscopic vascular stapler. Following occlusion of the veins there was a noted drop in blood pressure, typical of metabolically active pheochromocytoma. Blood loss was estimated at 200cc. Procedure was tolerated well.

Results:
Pheochromocytoma was successfully removed assistance from the DaVinci Robot. Blood loss and complications were minimal. Patient developed post operative ileus and was discharged home on post operative day 16.

Conclusion:
Robotic assistance allowed for limited manipulation of the lesion, reducing the risk of unsafe blood pressure spikes. Blood loss was minimized with the use of the Ethicon endoscopic vascular stapler.
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