Assessing Feasibility and Safety of Laparoendoscopic Single-Site Surgery Adrenalectomy: Initial Experience

Abstract

LESS adrenalectomy is feasible and safe, with favorable perioperative and short-term outcomes. It is technically more challenging than standard laparoscopy and requires advanced surgical skills. Prospective studies are needed for further conclusions.

Patient-reported satisfaction and cosmesis outcomes following laparoscopic adrenalectomy: laparoendoscopic single-site adrenalectomy vs. conventional laparoscopic adrenalectomy

“…18 Although several efforts have been made to further reduce invasiveness in laparoscopic adrenalectomy, at the end of the procedure, an incision was mandatory for specimen retrieval. 19 The most common position for access in LESS surgery has been the umbilicus for its cosmetic benefits. However, LESS-A through an umbilical access is extremely challenging due to the angle of approach and the difficulty in retracting organs.…”

“…19 LESS surgery should be explored with the greatest consideration placed on ethical and methodological issues. In our opinion, LESS-A is a safe technique resulting in improved cosmetic outcomes, with the additional benefit of being minimally invasive; however, long-term follow-up is necessary.…”

Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience

“…During the past few years, many clinical studies of LESS and animal experiments with NOTES for adrenalectomy have been conducted in many centers, leading to some inspiring results [12][13][14][15]. To our knowledge, these are the first reports of clinical research investigating TNLA.…”

Single-incision laparoscopic adrenalectomy

“…However, NOTES is technically challenging and improvements in the instrumentation used are required [1]. SILS is associated with fewer of these problems and has thus gained wider popularity for procedures such as appendectomy, cholecystectomy, splenectomy, nephrectomy, colorectal surgery, bariatric surgery, and adrenalectomy [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Although difficulties with reduced triangulation, fog evacuation, and clashing of the instruments have been described in various studies, these procedures are technically successful and the results indicate that this surgical approach is feasible.…”

“…Laparoscopic surgery for adrenal lesions has been shown to result in less pain, shorter hospital length of stay, faster recovery, and superior cosmesis. To date, only a few reports of single-incision laparoscopic adrenalectomy (SILA) have been published [14][15][16][17]. Despite residual controversies, these reports suggest that SILA may limit the morbidity and enhance the advantages of traditional laparoscopy.…”