MINIMALLY INVASIVE ADRENAL SURGERY

Nowadays, minimaly invasive operating techniques arp an essential part of adrenal gland surgery. Meanwhile four different methods are being used: laparoscopically in the supine or lateral position or retroperit oneoscopically as a prone or lateral method. Ideal indications for end oscopic adrenalectomy are adrenal hyperplasias and benign, hormonally active adrenal gland tumors up to 5 cm in diameter. In comparison to t he conventional operating procedures, the endoscopic methods have the advantage of less blood loss and minimized postoperative pain as well as shortening of hospital stay. Yet in contrast, the operating time of these procedures is prolonged. To date, it is not evident whether lap aroscopy or retroperitoneoscopy should be preferred. Laparoscopy offer s a familiar anatomical exposure but requires 5-6 trocars. For the ret roperitoneoscopic methods only 3 trocars are needed, but orientation i n the operating field is more difficult. All endoscopic procedures on the adrenal gland are technically difficult. They require a extended e xperience in minimally invasive surgery as well as special knowledge i n endocrine surgery.