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A mbad of more than 20 centimeters, located in the adrenal gland, was removed by a 39-year-old woman who had given birth in a few weeks. The operation, which lasted 3 hours and a half, was performed by the team of the operating room of the hospital "La Maddalena" Palermo
Palermo , July 3, 2018 – A solid-cystic tumor over 20 centimeters in diameter was removed with minimally invasive surgery at the La Maddalena Department of Cancer in Palermo. The bulky, benign mbad located in the right adrenal gland was completely removed by a 39-year-old woman a few weeks after delivery. The operation, which lasted 3.5 hours, was performed by the team of the complex surgical operating unit, composed by Pietro Mezzatesta, Lucio Mandalà, Luigi Casà and Antonio Noto.
The woman had discovered the neoplasm already in pregnancy, after checks at another health facility in the capital. After the initial percutaneous drainage to reduce the volume of the mbad, and promote the birth, we had initially hoped for a definitive resolution of the image without the need to intervene surgically.
Dott. Lucio Mandalà
Unfortunately, a few weeks after birth, the mbad reappeared until it reached enormous dimensions, so as to determine a remarkable compression and dislocation of the patient's internal organs (y including the liver and the right kidney) which he was experiencing increasingly severe disruptions
Thus, the woman decided to turn to the care of "La Maddalena", where before the surgery she underwent some diagnostic tests to investigate the nature of the mbad. 19659004] "The patient arrived with a report of presumed giant cytoplasm of the right lobe of the liver – explains Lucio Mandalà, chief of hepatobiliary surgery, who performed the operation as the first operator – this is explained in relation to the relationships that this mbad has contracted with the right side of the liver to not allow radiologists a reliable diagnosis of the origin of the neoplasia.The indication for intervention was determined by the severe symptomatology shown by the patient, by the tendency to relapse it was drained and especially by the need for a diagnosis of nature.So, after a consultation with the team, we decided to propose to the young woman to try to intervene in laparoscopy, and avoid an incision that would have been devastating to the new mother. "
" Surgical treatment with a minimally approach inv Asive the large abdominal mbades, regardless of their nature – explains the surgeon – is often contraindicated for unequaled technical difficulties. However, this possibility must always be evaluated in order to offer the highest standards of care that are now possible thanks to increasingly advanced technologies. It was a very complex operation during which we discovered that the solid component at the origin of this formation was the right adrenal gland and not the liver; an organ, the adrenal gland that is slightly larger than a chestnut and that in women was no longer recognizable because it was completely replaced by cystic neoplasia. "
" Just before the surgery – the surgeon continued – it was necessary to suck a part of the liquid component of the mbad so that the partial reduction of the volume of it can allow to proceed in laparoscopy, a method which, it is known, requires the injection into the abdominal cavity of an inert gas to create the anatomical space between the organs intervene. The operation began and ended with laparoscopy, with complete removal of the mbad and no incision on the patient. "
The intervention took place in November 2017 and is perfectly successful.The patient has recently undergone an initial check and is in good health.
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