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VR-9
(VS)
THE LAPAROSCOPIC NEUROBLASTOMA EXCISION
Mustafa KUCUKAYDIN, Necip Fazil ARAS, Ayse Betul OZTURK and Mahmut GUZEL
ERCIYES UNIVERSITY, PEDIATRIC SURGERY, Kayseri, TURKEY
PURPOSE
In this video, we want to present our experiences with laparoscopic neuroblastoma excision in two patients.
MATERIAL AND METHODS
Seven and 8 month-old-female and male infants were presented with left adrenal solid tumors (33x28x28 mm and
33x30x26 mm, retrospectively). Female patient’s tumor was detected in her intrauterine life with ultrasonography. The
size of tumor increased about 5 mm in her control ultrasonography.
The patient is placed a lateral decubitus position about 30-45˚ and three 5 mm throcar were used for the procedures. At
the beginning, the left colon is mobilized and retroperitoneal space, between the spleen and kidney, bluntly dissected.
Dissection of the retroperitoneal space reveals the left adrenal gland and tumor. Mobilization of the adrenal gland and
tumor and control of the blood supply is accomplished using Ligasure (Covidien©). After the adrenal gland and the
tumor is completely freed from surrounding tissues. The umbilical port is changed to the 10 mm port for insertion of
retrieval endosurgical bag. The tumor is placed into the handmade bag and extracted from the abdominal cavity through
the umbilical port.
RESULTS
Operation times are 30 and 45 minutes, retrospectively. Early postoperative periods were uneventful. The patients were
discharged from the hospital 3th postoperative day. Pathological and biological evaluations showed that one of tumor
unfavorable and other one favorable histology of neuroblastoma. Lymph nodes samplings were reactive. Chemotherapy
programs still continue in Pediatric Oncology Department.
CONCLUSIONS
We considered that the laparoscopic approach for the selected neuroblastoma in pediatric patients to be feasible, safe
and effective procedures.