Laparoscopic left adrenalectomy during Roux-en-Y gastric bypass using a supragastric approach.

A 54-year-old female had a BMI of 44 kg/m(2), biliary colic, gastro-eophageal reflux disease, joint pain, hyperlipidemia, and diabetes type 2. Her medical history included complete remission of non-Hodgkin's lymphoma and prolactinoma since 1999. An abdominal CT scan demonstrated an incidental left adrenal tumor, which had increased in diameter from 2 cm to 3 cm in 6 months. A laparoscopic Roux-en-Y gastric bypass with ultrasonography and supragastric left adrenalectomy were performed successfully. Combined surgical procedures appear to be suitable for treatment of coexisting abdominal pathologic findings with minimally invasive surgery. A supragastric approach should be considered when planning a simultaneous gastric bypass and left adrenalectomy.