Abstract
Background: Open adrenalectomy requires a large incision of the abdominal wall or lumbar region which is associated with considerable morbidity. The endoscopic approach to adrenal surgery has the potential to reduce patient discomfort. Methods: The retroperitoneal space is created by balloon dissection with the patient in lateral decubitus position. Incision of the lateroconal fascia and dissection of the upper renal pole allow access to the adrenal gland and its removal. All adrenal pathology less than 6 cm in diameter is suitable for the endoscopic retroperitoneal approach. Results: Endoscopic retroperitoneal adrenalectomy has proven safe and effective in adrenal pathology except for adrenal tumors greater than 6 cm in diameter or for patients who have had earlier retroperitoneal surgery on the affected side. Conclusions: Endoscopic retroperitoneal adrenalectomy appears preferable because the adrenal tumor can be approached in its proper anatomical plane. Therefore, dissection or retraction of surrounding organs is unnecessary which renders the adrenalectomy more facile.
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