Optimization of preoperative planning for laparoscopic adrenalectomy

Demin D.B.; Lyashchenko S.N.; Likhogray L.I.; Lebedenko S.A.

doi:https://doi.org/10.17116/hirurgia202605114

Demin D.B.

Orenburg Regional Clinical Hospital, Orenburg, Russia;
Orenburg State Medical University, Orenburg, Russia

ORCID: 0000-0002-9172-3081

Lyashchenko S.N.

Orenburg State Medical University, Orenburg, Russia

ORCID: 0000-0001-6467-2242

Likhogray L.I.

Orenburg State Medical University, Orenburg, Russia

ORCID: 0009-0002-1973-7929

Lebedenko S.A.

Orenburg State Medical University, Orenburg, Russia

ORCID: 0009-0002-8810-6477

Optimization of preoperative planning for laparoscopic adrenalectomy

Authors:

Demin D.B., Lyashchenko S.N., Likhogray L.I., Lebedenko S.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2026;(5): 14‑20

DOI: 10.17116/hirurgia202605114

Read: 366 times

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To cite this article:

Demin DB, Lyashchenko SN, Likhogray LI, Lebedenko SA. Optimization of preoperative planning for laparoscopic adrenalectomy. Pirogov Russian Journal of Surgery. 2026;(5):14‑20. (In Russ.)
https://doi.org/10.17116/hirurgia202605114

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

OBJECTIVE

To evaluate the effectiveness of preoperative CT in supine and lateral position for analysis of optimal trocar placement.

MATERIAL AND METHODS

We performed 32 laparoscopic adrenalectomies in patients with endocrine active adrenal glands. CT in lateral position was used for preoperative planning.

RESULTS

CT-based planning was carried out according to the above-mentioned methodology. Adrenal gland displacement was assessed in sagittal plane. Considering these data, we planned surgical action plane that made it possible to simulate necessary optical axis of laparoscope. According to CT data in lateral position, adrenal gland with tumor shifts anteriorly by 2.5-5 cm and medially by 2 cm. Depth of surgical action always decreases compared to supine position. If the distance between dorsal edge of tumor and anterior abdominal wall is 20 cm or more, trocar site is set along the mid-clavicular line in hypochondrium on the side of intervention, if less than 20 cm — along the mid-clavicular line in lateral area on the side of intervention.

CONCLUSION

CT in upcoming position allows us to preoperatively simulate intraoperative position of adrenal gland, assess its displacement and determine optimal trocar placement in a situation as close as possible to the operating theater, improve ergonomics and quality of surgical work, reduce the risk of intraoperative complications.

Keywords:

CT in upcoming position

preoperative planning

laparoscopic adrenalectomy

Authors:

Demin D.B.

Orenburg Regional Clinical Hospital, Orenburg, Russia;
Orenburg State Medical University, Orenburg, Russia

ORCID: 0000-0002-9172-3081

Lyashchenko S.N.

Orenburg State Medical University, Orenburg, Russia

ORCID: 0000-0001-6467-2242

Likhogray L.I.

Orenburg State Medical University, Orenburg, Russia

ORCID: 0009-0002-1973-7929

Lebedenko S.A.

Orenburg State Medical University, Orenburg, Russia

ORCID: 0009-0002-8810-6477

Received:

30.04.2025

Accepted:

21.07.2025

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References:

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