Laparoscopic Adrenalectomy: Where Do We Stand Now?

Karanikola, Evridiki; Tsigris, Christos; Kontzoglou, Konstantinos; Nikiteas, Nikolaos

doi:10.1620/tjem.220.259

Cited by 15 publications

(13 citation statements)

References 45 publications

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“…Thereafter, LA became the gold standard for adrenal masses smaller than 6 cm [2]. Laparoscopic surgery using both transperitoneal and retroperitoneal approaches are well established and suitable for adrenal surgery due to the difficult anatomic position of the gland [11]. New surgical techniques such as LESS are being developed in the light of new and minimally invasive methods.…”

Section: Discussionmentioning

confidence: 99%

Changing Surgical Approaches for Laparoscopic Adrenalectomy: Single-Surgeon Data of a 6-Year Experience

Arslan¹,

Akın²,

Ateş³

et al. 2013

Urol Int

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Aim: To evaluate outcomes of laparoscopic adrenalectomy (LA) and laparoendoscopic single-site surgery (LESS) for adrenal masses in the light of changing laparoscopic surgical techniques. Materials and Methods: Seventy-three patients were analyzed retrospectively. There were 2 groups; group 1 included patients who had conventional transperitoneal LA and transperitoneal LESS, and group 2 included patients who had lateral retroperitoneal LA, retroperitoneal LA in prone position, and retroperitoneal LESS. Demographic data, urine 3-methoxy-4-hydroxymandelic acid, normetanephrine, epinephrine, serum cortisol, aldosterone, adrenocorticotropic hormone, American Society of Anesthesiologists score, side and size of mass, conversion to open surgery, complications, estimated blood loss, operation time, pathological results were recorded and analyzed. Results: There was no difference in demographic data and serum parameters between both groups. Tumor size, estimated blood loss, operation time, transfusion rate and hospital stay were less for group 2 (p < 0.05, p = 0.0001). However, the complication rate was similar in both groups; in retroperitoneal prone position, the complication rate was less than for other surgical approaches, but statistically significant results could not be assessed. Conclusions: Even if the diameter of adrenal mass is larger than 6 cm, LA may be considered as the gold standard. The retroperitoneal approach especially in prone position may be a promising treatment method in the near future for adrenalectomy in selected patients.

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Section: Discussionmentioning

confidence: 99%

Changing Surgical Approaches for Laparoscopic Adrenalectomy: Single-Surgeon Data of a 6-Year Experience

Arslan¹,

Akın²,

Ateş³

et al. 2013

Urol Int

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“…Some authors consider the retroperitoneal approach more challenging to learn than the transabdominal anterior or flank approach and they believe there is a greater possibility for surgeons to become disoriented [23]. However, the retroperitoneoscopic route may be a better option in patients who had previous abdominal surgery [24].…”

Section: Discussionmentioning

confidence: 99%

Single‐Incision Transperitoneal Laparoscopic Left Adrenalectomy

et al. 2012

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“…While most publications support the size of 5 cm as “large”,[17–20] there are a few recent reports suggesting a size of 6 to 8 cm that should be treated as large. [2122] Analysis of our results had started in 2008 and hence the need to stick to 5 cm as the size to call it large. The mean size of the glands tackled was 7.03 cm that was similar to that published by Desai et al .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy for large tumours: Single team experience

Dalvi

Thapar

et al. 2012

J Min Access Surg

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BACKGROUND:Laparoscopic adrenalectomy (LA) has become the procedure of choice to treat benign functioning and non-functioning adrenal tumours. With improving experience, large adrenal tumours (> 5 cm) are being successfully tackled by laparoscopy. This study aims to present our single unit experience of LA performed for large adrenal masses.MATERIALS AND METHODS:Forty-six laparoscopic adrenalectomies performed for large adrenal lesions more than 5 cm during the period 2001 to 2010 were reviewed.RESULTS:A total of 46 adrenalectomies were done in 42 patients. The mean tumour size was 7.03 cm (5-15 cm). Fourteen patients had tumour size more than 8 cm. The lesions were localised on the right side in 17 patients and on the left side in 21 patients with bilateral tumours in 4 patients. Functioning tumours were present in 32 of the 46 patients. The average blood loss was 112 ml (range 20–400 ml) with the mean operating time being 144 min (range 45 to 270 min). Five patients required conversion to open procedure. Three of the 46 patients (6.52%) on final histology had malignant tumours.CONCLUSION:LA is safe and feasible for large adrenal lesions. Mere size should not be considered as a contraindication to laparoscopic approach in large adrenal masses. Graded approach, good preoperative assessment, team work and adherence to anatomical and surgical principles are the key to success.

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Laparoscopic Adrenalectomy: Where Do We Stand Now?

Cited by 15 publications

References 45 publications

Changing Surgical Approaches for Laparoscopic Adrenalectomy: Single-Surgeon Data of a 6-Year Experience

Changing Surgical Approaches for Laparoscopic Adrenalectomy: Single-Surgeon Data of a 6-Year Experience

Single‐Incision Transperitoneal Laparoscopic Left Adrenalectomy

Laparoscopic adrenalectomy for large tumours: Single team experience

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