Retroperitoneal Laparoscopic Surgery: Single Surgeon Experience

Laparoscopic Adrenalectomy for Treatment of Unilateral Adrenocortical Carcinomas: Technique, Complications, and Results in Seven Dogs

“…Comparative human studies have shown the benefits of minimally invasive techniques for removal of benign adrenal tumors (either functional or nonfunctional) of <12 cm in size 13–16 . Potential benefits of minimally invasive approaches include decreased requirements for analgesics, fewer adrenalectomy‐related complications, improved patient satisfaction, shorter hospital stays, and faster recovery periods when compared with open surgery 14–34 . Interestingly, laparoscopic ovariohysterectomy in dogs is associated with reduced postoperative pain and surgical stress compared with an open technique 35–37 .…”

“…Accordingly, it offers a large field of view that enables good orientation and an optimal observation of landmarks familiar from open surgical approach 14,16–18,21,22,31,33 . The retroperitoneal approach provides more direct access to the adrenal gland and can avoid abdominal adhesions in patients with previous abdominal surgery; however, dissection and exposure are more difficult, the working space is limited, and this approach does not allow a full abdominal exploration 19,22,30,38 . In the light of these caveats, as well as for body size, we chose the transabdominal laparoscopic approach for our dogs.…”

“…In humans, postoperative complications after laparoscopic adrenalectomy include bleeding, wound infection or hematoma, as well as thromboembolic, urinary, gastrointestinal, pulmonary, and cardiovascular problems 16,20–27,30 . Injury to peritoneal and retroperitoneal organs (liver parenchyma, spleen, pancreas, colon, lymphatic system, and adrenal gland) accounts for <5% of all complications 15,32,33 .…”

“…Laparoscopic adrenalectomy in humans was reported in 1992 11,12 and is most often used for benign functional and nonfunctional tumors (<12 cm in size) of the adrenal glands 13–16 . Laparoscopic adrenal surgery may offer several advantages including fewer wound complications, reduced morbidity, improved comfort and cosmetic appeal, reduced bleeding, better observation of abdominal organs, shorter hospital stays, and faster recovery periods 14–34 . Advantages of minimally invasive surgical procedures in dogs compared with open surgical procedures have been reported and laparoscopic ovariohysterectomy reduces postoperative pain and surgical stress compared with the open technique 35–37 …”