ENDOSCOPIC SURGICAL THERAPY OF ACCIDENTAL LY DIAGNOSED TUMORS OF THE ADRENAL-GLAND

Since 1992 endoscopic surgical techniques have gained importance in ad renal gland surgery. In this review the actual laparoscopic and retrop eritoneoscopic techniques and results - taking the own case material i nto consideration - are represented. The laparoscopic, transperitoneal adrenalectomy shows a low rate of complications (12%). Disadvantages of the transperitoneal approach are the risk of an intraabdominal inju ry and the problems caused by adhesions after abdominal operations. Th e retroperitoneoscopic access to the adrenal gland avoids disadvantage s of the transperitoneal approach. Concerning the rising frequency of accidentally diagnosed tumors of the adrenal gland the retroperitoneos copic approach represents a technique which allows a removal of these tumors up to a size of 6 centimeters with low morbidity. In case of la rge tumors of the adrenal gland (size > 6 centimeters) suspected for m alignancy we see the indication for the transperitoneal approach.