Laparoscopic adrenalectomy

Surgical treatment of pheochromocytomas

“…However, the suspicion of adrenal malignancy is considered to be a contraindication for laparoscopic adrenalectomy [6,15,19]. Although a large number of endoscopic adrenalectomies for pheochromocytoma have been reported [4,6,8,12,14,15,24,27], some authors are reluctant to use this technique for the removal of catecholamine-secreting tumors [22,26]. In our series, pheochromocytoma has been the most frequent indication for laparoscopic adrenalectomy next to primary hyperaldosteronism (Conn's syndrome).…”

“…The latter require a balloon trocar, which is expanded in the retroperitoneal fat at the beginning of the procedure to create a space similar to that in endoscopic preperitoneal hernia repair [10]. Like many other authors [3,12,14,15,17,23,24], we prefer the laparoscopic transperitoneal techniques. After our first 28 laparoscopic adrenalectomies, which had been performed with the patient in the lithotomy position, we changed our technique to the transperitoneal approach with the patient in the lateral decubitus position as described by Gagner et al [6].…”

Laparoscopic Adrenalectomy

“…68,69,[71][72][73] The results of the less commonly utilized anterior transabdominal approach are summarized in Table 26.4. 70,[87][88][89] Earlier reports of this procedure were associated with prolonged operative times and increased blood loss compared to the lateral transperitoneal approach. However, Filipponi and colleagues 70 recently achieved results comparable to the lateral approach in a large series of adrenalectomies.…”

Laparoscopic adrenal surgery

“…Wie viele andere Autoren [6,19,21,24,36,39,43,45] bevorzugen auch wir die laparoskopische Adrenalektomie in Rü cken-oder Steinschnittlage des Patienten. Durch Kippen des Operationstisches zur Gegenseite oder Unterlegen von Kissen kann die Exposition erleichtert werden.…”

“…Es fä llt zunä chst auf, daß nur sehr selten ü ber Umstiege auf eines der konventionellen Operationsverfahren berichtet wird [4,6,10,16,20,21,40,[43][44][45]. Zumeist waren diese wegen nicht beherrschbarer Blutungen oder einer mangelnden Exposition des Operationsgebietes erforderlich.…”