Abdominelle Voroperationen

Abstract

Benign adrenal gland tumors smaller than 6 cm are nowadays the indication for minimally invasive surgery. Until now there has been no significant difference between retroperitoneoscopic and transabdominal adrenalectomy. Intestinal adhesions could be a contraindication against transabdominal laparoscopic adrenalectomy, and therefore the retroperitoneoscopic approach could be an advantage in these cases. A prospective study concerning this question has not been published yet. Our clinical investigation here includes 114 adrenalectomies during the last 5 years. We show that in any case of abdominal preoperation, laparoscopic adrenalectomy can be performed by transabdominal approach and without conversion to open surgery. Discussed are the different indications for laparoscopic adrenalectomy, operating time, conversion rate to open surgery, and amount and type of abdominal preoperation. We compared patients with and without abdominal preoperations.

No Outcome Differences between a Laparoscopic and Retroperitoneoscopic Approach in Synchronous Bilateral Adrenal Surgery

“…The main surgical advantages of this approach are represented by the possibility of having very good control of all vascular structures, exploiting gravity to better expose the operative field, and being able to treat other abdominal pathologies simultaneously, including gallstones and ovarian cysts, among others. However, endoperitoneal adhesions in patients who have previously undergone abdominal surgery may present some limitations, even though some case reports of successful laparoscopic adrenalectomies in redo surgery have been published [18].…”