Focus on vascular dissection during left robotic adrenalectomy

A 48-year-old female patient with refractory hypertension underwent left robotic adrenalectomy for a Conn’s adenoma. Preoperative imaging analysis revealed the presence of a left superior polar renal artery.

After identification of the left renal vein and transection of the adrenal vein, careful dissection of the adrenal gland using robotic monopolar scissors confirmed the superior left polar renal artery, with an accessory adrenal artery that was selectively controlled.

Pre-operative CT scan allowed us to assess the vascular anatomy and conduct cautious dissection using robotic monopolar scissors instead of a vessel sealer or ultrasonic energy device, thereby reducing the risk of iatrogenic vessel injury with major bleeding.