Persistent hypokalemia due to Conn’s syndrome resolved by robot-assisted laparoscopic adrenalectomy. A correct diagnostic approach for proper surgical therapy. Case report

Primary hyperaldosteronism, or Conn's syndrome, is a leading cause of secondary hypertension, often presenting with persistent hypokalemia. We report the case of a 44-year-old female with refractory hypokalemia and hypertension, ultimately diagnosed with a unilateral aldosterone-producing adenoma. Diagnostic workup included elevated transtubular potassium gradient and aldosterone-to-renin ratio, confirmed by computed tomography imaging showing a typical left adrenal adenoma. The patient underwent robot-assisted laparoscopic adrenalectomy, resulting in normalized potassium levels and discontinuation of antihypertensive medications. Histopathology confirmed adrenal adenoma. This case underscores the importance of a structured diagnostic algorithm in detecting surgically correctable causes of secondary hypertension. Robotic-assisted surgery offered superior precision, minimal blood loss, and rapid recovery, proving especially advantageous in complex or reoperative cases. In resource-limited settings, where advanced technology is scarce, promoting diagnostic accuracy is vital for effective management. This case advocates for the broader adoption of minimally invasive approaches and encourages investment in surgical innovation in developing countries.