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Record intervention at La Maddalena. A mbad of more than twenty centimeters, located in the adrenal gland, was removed by a 39-year-old woman who had given birth within a few weeks of a minimally invasive surgery. The operation, which lasted three and a half 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 neoplasia already pregnant, following a few checks at another health facility in Palermo. "After the initial percutaneous drainage to reduce the volume of the mbad, and to encourage childbirth, it was first hoped – they explain the private structure – a definitive resolution of the framework without the need for". unfortunately, a few weeks after delivery, the mbad reappeared until it reached enormous dimensions, so as to determine a remarkable compression and dislocation of the patient's internal organs ( including the liver and the right kidney) who was experiencing more and more disruptions at the care of "La Maddalena", where, before the prospect of surgery, she underwent some diagnostic tests to investigate the nature of the mbad ".
"The patient arrived with a suspected giant cytoplasmic report of the right hepatic lobe – says 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 should 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. "
The intervention, which took place in November 2017, she started and ended born by a laparoscopy, with a complete removal of the mbad and without incision on the patient. He concludes the surgeon at 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 in the standard has dimensions slightly greater than a chestnut and that in the woman was no longer recognizable as completely replaced by a cystic neoplasm. Just before the intervention it was necessary to suck up a part of the liquid component of the mbad so that the partial reduction of the volume of it allows to proceed in laparoscopy, a method that, as we know, requires the introduction into the abdominal cavity of an inert gas create the anatomical space between the organs on which to intervene. The intervention is perfectly successful. The patient has recently had a first visit and is in good health. "
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