TECHNIQUE AND RESULTS OF THE RETROPERITONEOSCOPIC ADRENALECTOMY VIA ALUMBAR APPROACH

Introduction: Since 1992, endoscopic techniques have been used increas ingly in adrenal-gland surgery. In the present paper, the technique of the retroperitoneoscopic adrenalectomy via a lumbar approach is descr ibed. Methods: The patient is placed in a lateral decubitus position. In the first step, a dilatation trocar is introduced in the retroperit oneal space to create an artificial cavity. The dilatation trocar is r eplaced by a blocking trocar to close off the operating field. After i nsufflation of CO,, two additional trocars are introduced in the area of the conventional flank incision. Adrenalectomy is performed via the se ports. Once the adrenal gland is completely mobilized, it is insert ed into a sterile plastic bag and removed through the 1.5-cm incision. Conclusion: The retroperitoneoscopic approach to the adrenal gland ap pears to be suitable for benign adrenal-gland tumors up to a size of 6 cm.