Outpatient laparoscopic adrenalectomy in patients with Conn's syndrome

Backround: We set out to record the operative times of an experienced lapar oscopic team and assess the feasibility of outpatient laparoscopic adrenale ctomy when optimal anesthesia was also offered to all patients. Methods: The study included 13 patients with aldosterone/cortisone hypersec retion and/or adrenal gland tumors, excluding those with pheochromocytoma. They had to live within 30 min travel from the hospital, and adult company had to be present at home. All patients received general intravenous anesth esia with propofol and remifentanil and were given keterolac, propacetamol, droperidol, and ondansetron as prophylaxis against postoperative pain and nausea. Laparoscopic adrenalectomy was performed by the transabdominal late ral flank approach. Postoperatively, all patients were contacted by phone i n the evening and the next morning. Results: All 13 patients were discharged 3-6 h postoperatively. None were r eadmitted; thus, the day care success was 100%. The mean operative time was 38 min (range, 35-112). Patient satisfaction was excellent in all but one case, due to pain on the Ist postoperative day. Conclusion: Laparoscopic adrenalectomy can be a fast operation. It is feasi ble and safe and yields satisfactory results for patients as an outpatient procedure when the necessary surgical experience and optimal anesthesia are both available.