Laparoscopic adrenalectomy has become the method of choice of removal of most of adrenal lesions. This study investigated and compared the results of 2 different approaches of laparoscopic adrenalectomy, through retrospective review of 40 patients. Within this study period between 1995 and 2004, there were 20 lateral retroperitoneal and 20 lateral transperitoneal laparoscopic adrenalectomies performed. There was no significant difference in demographic variables between the 2 groups. Operative time, days to diet and ambulation, hospital stay, rate of conversion and complication did not differ significantly between the 2 approaches. No recurrence was detected upon mean follow-up period of 15.9 months. Learning curves showed gradual decrease in operation time in both approaches, reflecting maturation of techniques. In conclusion, both lateral transperitoneal and lateral retroperitoneal laparoscopic adrenalectomy are safe and effective. There is no difference in outcome between 2 approaches.

The reported incidence of bladder injury after cesarean section ranges from 0.14% to 0.94%. Most of the injuries were found intraoperatively. Delayed presentation is rare. We report a patient with bladder perforation presented with 'acute renal failure' and ascites 14 days after an uneventful cesarean section. Her clinical picture and initial presentation mimicked those of ureteric injury. Conventional cystography failed to demonstrate the bladder perforation. Computed tomography cystography clarified the diagnosis. Subsequent laparoscopic bladder repair resulted in quick and smooth recovery. This case highlights the pitfall of conventional cystography and the successful use of laparoscopy in management of this urologic condition. Literature was reviewed for this condition and its management.

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had smooth recovery and voided with a better stream. Histopathology revealed unusual cystic mixed epithelial and stromal tumour.CONCLUSIONS: Meticulous dissection in laparoscopy is essential for a complete removal of seminal vesicle cyst.