Left Adrenalectomy:
The Told line was incised from splenic flexure to the sigmoid junction to mobilization the left colon. After reflecting the descending colon medially, the dissection was carried out between Gerota’s fascia and the mesocolon up to access to the renal and adrenal vein. Dissection of the adrenal gland before vascular control was avoided to prevent the systemic release of catecholamines. The adrenal vein was controlled using Hem-o-Lock clips, and dissection was continued from just superior to the renal vein until the psoas muscle was identified. The tissue was manipulated without directly grasping the adrenal gland to avoid bleeding and potential hemodynamic instability. The medial dissection was carried out from the renal vein to the crus of the diaphragm. An ultrasonic scalpel was used to control small vessels. Once the medial dissection was completed, lateral dissection was extended between the renal cortex and perinephric fat adjacent to the adrenal gland. The specimen was removed using an endopouch.