Outpatient adrenalectomy

Purpose: To our knowledge we report the initial experience with outpatient, same day laparoscopic adrenalectomy. Materials and Methods: Nine select patients were entered into our ambulator y adrenalectomy protocol. Each patient fulfilled certain preoperative and p ostoperative inclusion criteria, including informed consent, age 70 years o r older, body mass index 40 or less, adrenal tumor less than 5 cm., no pheo chromocytoma, uncomplicated laparoscopic surgery that was completed by 12 p .m., perioperative hemodynamic stability and pain control by oral analgesic s. Results: All 9 patients successfully underwent outpatient laparoscopic adre nalectomy. Average patient age was 53 years and average adrenal tumor size was 2 cm. Mean surgical time was 2.3 hours and mean blood loss was 53 ml. T he diagnosis was aldosteroma in 7 cases, enlarging adenoma in 1 and myeloli poma in 1. Average postoperative hospital stay was 416 minutes (range 300 t o 570). Postoperative analgesia comprised 6 mg. morphine sulfate and 32 mg. ketorolac, The only complication was a local abscess requiring delayed dra inage at 2 weeks. No other patient was rehospitalized for any reason. A fol lowup questionnaire survey revealed excellent patient satisfaction. Conclusions: To our knowledge we report the initial series of outpatient la paroscopic excision of a solid organ, the adrenal gland. Ambulatory adrenal ectomy is feasible and safe, and results in high patient satisfaction. Howe ver, ambulatory adrenalectomy should be restricted to highly select, patien ts and performed by minimally invasive surgeons who have considerable exper ience with laparoscopic adrenal surgery.