Laparoscopic Left Adrenalectomy Periprocedural Care

Updated: Jun 20, 2023
  • Author: Michael S Lasser, MD, FACS; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care

Patient Preparation

The patient is placed into the right lateral decubitus position (left side up) at approximately 60-90º. All pressure points are adequately padded, an axillary role is placed, the bed is flexed, the kidney rest is elevated just cephalad to the level of the iliac crest, the arms are secured into the anatomic position with adequate padding, and the patient is secured to the table.

The use of a beanbag can facilitate positioning and provide an additional layer of security when the patient is being secured to the surgical table. The beanbag should not be deflated until the bed is flexed and the patient adequately positioned.

The use of this lateral decubitus positioning allows the intra-abdominal viscera to fall away from the adrenal gland for easier dissection and provides maximal opening of the space between the iliac crest and the costal margin for optimal trocar placement. Open conversion, if necessary, will be facilitated by the use of this positioning.