One hundred and ten consecutive uncomplicated retroperitoneal videoscopic adrenalectomies – Polish multicentre study

Posterior Retroperitoneoscopic Adrenalectomy: A Comparison between the Initial Experience in the Invention Phase and Introductory Phase of the New Surgical Technique

“…Moreover, patients after transperitoneal laparoscopic adrenalectomy develop port site hernias in about 10% of cases, whereas in patients after retroperitoneal adrenalectomy this rarely occurs 17. Despite these benefits, many endocrine surgeons are still afraid of the retroperitoneal adrenal surgery, considering it difficult because of the uncommon anatomic view related to reverse positioning of the patient and long learning period necessary to master the procedure 14–19…”

“…Because of its high degree of difficulty in the beginning, related to the uncommon operating view, extended expertise in endoscopic surgery is necessary. Assistance by a surgeon experienced in PRA and visits to centers with appropriate experience are strongly recommended before a surgeon adopts this method, as both these factors dramatically flatten the learning curve and ensure safety for the patient and surgeon confidence throughout the entire operation 19,21,26. It seems that about 20–25 PRAs are necessary for surgeons learning this new technique to allow them to complete the operation with a mean operating time below 90 minutes.…”

“…11,[12][13][14][15][16][17] However, retroperitoneoscopic adrenal surgery is uncommon, as many endocrine surgeons consider this approach technically challenging. [15][16][17][18][19] The present study aimed at comparing the learning period of the initially new procedure of ''posterior retroperitoneoscopic adrenalectomy'' (PRA) in the primary invention phase and in the secondary introductory phase in a different hospital 10 years later.…”

Cushing’s Syndrome: Adrenalectomy and Long-Term Results

“…With the introduction of the retroperitoneal endoscopic approach, as a gentle and safe operation technique, surgery with a low morbidity and mortality can now be offered to more patients. In the case of patients with unilateral benign adrenal lesions the adrenalectomy should be performed by means of an endoscopic approach in a specialized center [24, 25]. Due to their small size with a diameter of less than 5 cm, cortisol-secreting adrenal adenomas are very suitable for endoscopic surgical techniques.…”

Posterior Retroperitoneoscopic Adrenalectomy - Clnical Evaluation of the Method Based on the Four-Year Experience

“…The originator of the method has employed the technique in more than 600 operations and contributed to its extensive popularization worldwide, what is supported by a growing number of leading centers of endocrine surgery where the method has been introduced into practice (27). The PRA technique is presently regarded by numerous surgeons to provide the optimum access to the adrenal gland, although the lateral retroperitoneoscopic approach continues to be successfully employed in infrequent centers (12,13,28). In prospective randomized trials reported to date, which compare laparoscopic adrenalectomies with PRA procedures, the authors emphasize the advantage of the latter consisting in a significant reduction of the operative time, especially in operations performed on the left side and in the case of small tumors (e.g.…”