Background: Laparoscopic Adrenalectomy (LA) has rapidly become the gold standard in management of adrenal tumors as it has been found to be associated with better cosmoses, shorter hospital stay and rapid convalescence. Objective: The aim of this study was to compare laparoscopic and open approach to adrenal glands in terms of operative time, hospital stay, indications and blood loss at a tertiary medical center in Jordan. Methods: A retrospective comparative study which included all patients who underwent adrenalectomy (open or laparoscopic) from 2005 to 2015 at King Hussein Medical Center (KHMC). Patients’ demographics ,outcomes and essential study variables were extracted from patients’ files. Data analysis was performed using SPSS17 and Stata 10. Results: One hundred and three patients (mean age 44.9 years) were included, 90.2% of them underwent laparoscopic adrenalectomy. The size of the tumors ranged from 2 to 17 cm (mean 6.6 cm).The operative time, blood loss and hospital stay were significantly less in the laparoscopic group (P value <0.001). Patients in Open group had a significantly higher risk of incomplete excision of the tumors (P value=0.020). Conclusion: Laparoscopic adrenalectomy is associated with decreased operative time, blood loss and hospital stay compared to open approach. Tumor size and its malignant potential should be no more regarded as an absolute contraindication to laparoscopic adrenal surgery.

Objectives: To assess the effect of staple-line reinforcement on the rate of staple-line leak and bleeding post laparoscopic sleeve gastrectomy. Methods: In this retrospective study we analyzed 326 patients who underwent laparoscopic sleeve gastrectomy at King Hussein Medical Center between January 2010 and April 2016. Staple-line reinforcement using continuous lembert suture method was used in 229 patients (reinforcement group) while it was not used in 97 patients (non-reinforcement group). Patient characteristics, comorbidities, duration of surgery, hospital stay, as well as complications including staple-line leak and bleeding after surgery were obtained, analyzed and compared between the reinforcement and non-reinforcement groups. Results: Patients of the reinforcement group had baseline characteristics and comorbidities similar to those in the non-reinforcement group but had two cases of leak (0.87%) and two cases of bleeding (0.87%).While patients of the non-reinforcement group had one case of leak (1.03%) and five cases of bleeding (5.15%). Although there was no significant difference regarding leak rate between the two groups (P =1.000), bleeding rate was significantly decreased in the reinforcement group (P=0.026). One of the patients with leak died in the reinforcement group while there were no deaths in the non-reinforcement group. Conclusion: According to our results; reinforcement of the staple-line by lembert suture in laparoscopic sleeve gastrectomy reduced the incidence of staple-line bleeding but was associated with prolongation in operation time compared with no staple-line reinforcement. While the difference in leak rate between the two groups was not significant.