Exploration on the application of laparoscopic anatomical concepts in prone dorsal approach adrenal surgery

doi:10.13418/j.issn.1001-165x.2026.1.13

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Chinese Journal of Clinical Anatomy ›› 2026, Vol. 44 ›› Issue (1) : 85-89. DOI: 10.13418/j.issn.1001-165x.2026.1.13

Exploration on the application of laparoscopic anatomical concepts in prone dorsal approach adrenal surgery

Yang Li, Xiao Zhisong, Zheng Baoshou, Zhang Aijian, Li Yunpeng, Li Xingjie

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Abstract

Objective To explore the application of anatomical concepts for searching for "vascular landmarks" and constructing "mesenteric ridge" during prone dorsal approach laparoscopic adrenalectomy. Methods A retrospective analysis was conducted on 62 patients who underwent prone dorsal approach laparoscopic surgery in the First Affiliated Hospital of Dali University from Sep. 2022 to Mar. 2025. Intraoperative laparoscopic video data and perioperative indicators were reviewed. From the videos, summaries were made as follows: First, exposed the surgical field of subdiaphragmatic adrenal region by dissection. Then, identified the anatomical landmarks using inferior phrenic vein (left side) and inferior vena cava (right side) as "vascular landmarks," and dissected the medial aspect of gland. Dissected adrenal gland from lateral side and identified the lower plane of adrenal gland on lateral side, then used the anatomical landmarks to relocate and expose central vein. Detached from the peritoneal plane of gland to vascular margin on the inner side of gland, constructing a "mesenteric ridge" composed of an arterial arch network resembling "comb-like blood vessels" on the inner side of gland and central vein. Finally, performed total or partial adrenalectomy. Results All surgeries were successfully completed without intraoperative or postoperative complications. The average operation time was (32.48±6.02) min, intraoperative blood loss was 15 (10~25 mL), and postoperative hospital stay was 3 (3~4) days. Conclusions The anatomical concepts of identifying "vascular landmarks" and constructing "mesenteric ridges" provide a standardized reference for laparoscopic adrenal surgery via prone dorsal access, facilitating surgical technique optimization and quality improvement.

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Prone position / / / Laparoscopy / / / Anatomy / / / Adrenal surgery

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Yang Li, Xiao Zhisong, Zheng Baoshou, Zhang Aijian, Li Yunpeng, Li Xingjie. Exploration on the application of laparoscopic anatomical concepts in prone dorsal approach adrenal surgery[J]. Chinese Journal of Clinical Anatomy. 2026, 44(1): 85-89 https://doi.org/10.13418/j.issn.1001-165x.2026.1.13

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