Laparoscopic Adrenalectomy

Abstract

Using the transperitoneal, laparoscopic approach, we performed 67 successful adrenalectomies between June 1993 and July 1995 at Greenslopes Hospital, Brisbane. There were 30 women and 37 men. Syndromes of primary adrenal hormone overproduction--primary aldosteronism (n = 52), pheochromocytoma (n = 6), and hypercortisolism (n = 1)--were present in 59 patients and apparently nonfunctioning adrenal tumors (of which one was malignant) in 8 patients. There was a significant difference in the time of operation between patients weighing < 80 kg and those weighing > 80 kg. Operations on males were slower than those on females, possibly explained by males being significantly heavier. Left-sided tumors outnumbered right-sided tumors; removal of right-sided adrenals took, on average, longer, but this difference was not significant.

Complications of Laparoscopic Adrenalectomy in 75 Patients Treated by the Same Surgeon

“…This complication rate is also similar to that already reported for laparoscopic adrenalectomy [6, 7, 8, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]and for other laparoscopic surgeries with complex procedures such as laparoscopic radical nephrectomy (34%) [23]and laparoscopic pyloromyotomy (21.2%) [25]. Although the complication rate was higher than that of gynecological laparoscopy (1–4%) [23]or laparoscopic cholecystectomy (9.6%) [27], the rate was lower in the latest 35 patients undergoing laparoscopic or retroperitoneoscopic adrenalectomy (17.1%).…”

“…In this series, 5 of 75 patients (6.7%) were converted to open surgery including 1 emergency and 4 elective conversions. The conversion rate is similar to that of other reported series, such as about 5% (0–17%) for laparoscopic adrenalectomy [6, 7, 8, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22], 3% for laparoscopic simple nephrectomy [23], 16% for laparoscopic radical nephrectomy [23], 7% for laparoscopic colectomy [24], 12.2% (3% emergency and 9.1% at subsequent surgery) for laparoscopic pyloromyotomy [25], and 4% for laparoscopic hysterectomy [26]. …”

Primary Aldosteronism: Changing Definitions and New Concepts of Physiology and Pathophysiology Both Inside and Outside the Kidney

“…Laparoscopic adrenalectomy is now the favored surgical approach as it is associated with less pain and a shorter time to recovery than with the previously used open technique (166,446). Conversion to an open operation is rarely required, the usual prompts being unusual anatomy or significant obesity (446).…”

“…Conversion to an open operation is rarely required, the usual prompts being unusual anatomy or significant obesity (446).…”

Adrenalectomy for Familial Pheochromocytoma in the Laparoscopic Era

“…10,[13][14][15][51][52][53][54] In the present study, two patients were converted to an open procedure. These 2 were the only conversions to open adrenalectomy in a total of 72 patients (conversion rate 3%) with functioning adrenal tumors approached laparoscopically by our group.…”