Laparoscopic adrenalectomy: a study of 137 cases

Purpose. Laparoscopic adrenalectomy has become the "gold standard" of adrenal surgery. In this paper the Authors report their experience with this technique. Methods. The study includes 137 patients who underwent laparoscopic adrenalectomy between June 1993 and December 1999. There were 76 females and 61 males, with a mean age of 51.4 years. The right adrenal gland was involved in 71 cases, the left in 64. Bilateral involvement was found in 2 patients. Results. Mean operative time was 87 minutes. Mean size of the removed tumors was 39 mm. Another procedure was associated in 6 cases (4.4%). In 5 cases (3.6%), conversion to an open approach was required, because of bleeding (3 cases), difficult dissection (1), or cardiovascular failure (1). The postoperative rate of complications was 3.6%, mainly due to bleeding (4 cases). Conclusions. Laparoscopic adrenalectomy offers numerous advantages with respect to the conventional approach. It can be safely undertaken for large and/or potentially malignant adrenal lesions, for pheochromocytoma, and for metastatic lesions.