Laparoscopic retroperitoneal adrenalectomy: a reliable and reproducible technique.

Introduction: Laparoscopic adrenalectomy has become one of the reference te chniques for resection of small tumours of the adrenal gland. The objective of this study was to evaluate the retroperitoneal approach in terms of its intraoperative complication rate, morbidity, and length of hospital stay, comparing two centres using the same surgical technique. Material and Method: Between January 1995 and March 2000, two different cen tres respectively performed 55 and 60 laparoscopic adrenalectomies (70 left , 45 right) using a retroperitoneal incision in 106 patients (64 women and 42 men) with a mean age of 49.3 years (range: 17 to 74 years). The mean siz e of the adrenal tumour was 31 mm (range: 10 to 61 mm). Five trocars were u sed in every case. Results: No difference was observed between the two centres in terms of ope rating time (100 min vs 135 min), conversion rate (0% vs 1.7%), and blood l oss (74 ml vs 80 ml). With a mean follow-up of 23.4 months, no difference w as observed for morbidity, rate (12.7% vs 16.7%), including intraoperative complications (1.8% vs 5%) with 3 vascular injuries, and postoperative comp lications (10.9% vs 11.7%) comprising wound abscesses, deep haematomas, a h ernia at the trocar orifice and one case of severe pneumonia. The mean hosp ital stay was 3 days vs 5 days with a mean duration of analgesic consumptio n of 2 days (range: 1 to 5 days). Conclusion: Laparoscopic retroperitoneal adrenalectomy appears to be a reli able and reproducible approach for resection of adrenal gland tumours less than 6 cm in diameter.