Laparoscopic Adrenalectomy By The Transperitoneal Approach And Typical Complications: Own Experience And Review Of Current Literature

Abstract

Minimally invasive techniques play an increasingly important role in adrenal surgery. We report typical complications we have encountered. Between 1997 and 2003, 52 patients were referred to our centre for the surgical management of adrenal diseases. A laparoscopic approach was chosen for 25 patients. Indications for surgery were Conn's adenoma, phaeochromocytoma, Cushing's-adenoma, virilizing tumour, incidentaloma and lung cancer metastasis. Conversion to laparotomy in 4 patients was due to morbid obesity, inhalatory problems with anaesthesia, anatomical difficulties in surveying the surgical field, and intraoperative bleeding. Eight patients underwent partial adrenalectomy. LA is the treatment of choice for small benign tumours with a low rate of mortality and acceptable risk of morbidity. Because of the rare incidence of adrenal tumours, it will never be a common procedure and will become established primarily in centres with appropriate expertise in laparoscopic and endocrine surgery.