J Korean Surg Soc.  2000 Aug;59(2):200-205.

Experience with a Retroperitoneoscopic Adrenalectomy: Results of 41 cases

Affiliations
  • 1Department of Surgery, Ulsan University College of Medicine, Seoul, Korea.
  • 2Department of Endocrinology and Metabolism, Ulsan University College of Medicine, Seoul, Korea.

Abstract

PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations.
METHODS
From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1-6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.

Keyword

Retroperitoneoscopic adrenalectomy; Laparoscopic adrenalectomy; Retroperitoneal approach

MeSH Terms

Adenoma
Adrenalectomy*
Angiomyolipoma
Hemorrhage
Humans
Hyperplasia
Kidney
Length of Stay
Mortality
Nephrectomy
Prone Position
Subcutaneous Emphysema
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