Laparoscopic adrenalectomy - A review of 30 initial cases

Background: Laparoscopic adrenalectomy is a good option for removal of the adrenal gland that is becoming preferred over the conventional open techniq ue. Methods: We reviewed the initial 30 laparoscopic adrenalectomies (in 27 pat ients) that were performed at: our institution from 1995 to 1998, We used t he lateral decubitus transperitoneal approach in 26 cases and the retroperi toneal approach in only one case. The indications for adrenalectomy were Co nn's adenoma in eight patients, pheochromocytoma in six, Gushing's syndrome in five, nonfunctional adenomas in seven, and metastasis in one case. Results: Only two patients (7%) were converted to laparotomy. Operating tim e ranged from 75 to 240 min. Average adrenal gland size was 6.1 cm (range, 4-9 cm), There was no mortality, and morbidity occurred in only two patient s (8%)-one case of self-limited gastrointestinal bleeding and one case of h ypercapnia and subcutaneous emphysema (in the only patient operated by the retroperitonal approach). Mean hospital stay was 3 days (range, 1-6). Conclusions: Laparoscopic adrenalectomy is a safe and useful procedure for nearly all adrenal pathologies. Lateral decubitus transperitoneal approach is the procedure of choice in most cases.