LAPAROSCOPIC ADRENALECTOMY FOR ADRENAL-TUMORS CAUSING HYPERTENSION AND FOR INCIDENTALOMAS OF THE ADRENAL ON COMPUTERIZED-TOMOGRAPHY SCANNING

1. In a 19 month period from June 1993 to December 1994, 60 patients ( mean age 54.8 +/- 1.5 years s.e.m.; 32 males, 28 females) underwent un ilateral laparoscopic adrenalectomy by one of us (JCR) for the treatme nt of hypertension due to primary aldosteronism (n = 48), phaeochromoc ytoma (n = 3) and cortisol-producing adenoma (n = 1) or to remove adre nal masses incidentally discovered on abdominal computerized tomograph y scanning ('incidentaloma') performed for other reasons (seven adenom as without biochemical evidence of excessive steroid hormone or catech olamine secretion and one carcinoma autonomously producing cortisol). 2. Compared with conventional open procedures, laparoscopic adrenalect omy was associated with reduced recovery time and a low complication r ate (one pulmonary embolus and one port site incisional hernia). 3. Op eration time with experience approximates that of open procedures (60 min), but is significantly longer in obese than in non-obese patients, and in males than in females. 4. Patients with adrenal causes of hype rtension were cured or significantly improved by laparoscopic unilater al adrenalectomy. 5. Because of our concern regarding malignant potent ial of incidentalomas and high patient acceptance of laparoscopic tech niques, we have reduced our size criteria for removal of incidentaloma s.