Retroperitoneal laparoendoscopic single-site surgery: preliminary experience in the feasibility and safety of adrenalectomy

Abstract

Objective To verify the safety and feasibility of retroperitoneal laparoendoscopic singlesite surgery (LESS) adrenalectomy in the treatment of adrenal gland tumors or cyst. Methods From Oct.2009 to Jan.2012,7 patients underwent retroperitoneal LESS adrenalectomy with Quadport technology by one surgeon.The mean patient age was 46 ( 39 - 55 ) years.The mean largest tumor diameter was 2.3 (1.8-3.6) cm.All procedures were performed through retroperitoneal approach by using Quadport,tip flexible laparoscope with 0° lens and conventional laparoscopic instruments.This technique was evaluated in respects of operative time,estimated blood loss,intraoperative complications,drainage time,visual analog pain scale (VAPS) score,post-operative hospital stay and pathological results. Results Seven cases of LESS adrenalectomy were completed successfully.There was no additional trocar added,no conversion to conventional laparoscopic or open approach.The mean operative time was 106 (70 - 180) min,and the mean estimated blood loss was 59 (5 -200) ml.The mean first day post-operative VAPS score was 2 (1 -3),drainage time was 2 (2 -3) d.Post-operative hospital stay was 5 (3 -6) d.No perioperative complication was observed.Pathological results showed 1 case of adrenal pheochromocytoma,5 cases of adrenal cortical adenoma and 1 case of adrenal cyst. Conclusion Retroperitoneal LESS adrenalectomy is a safe and feasible option for the treatment of adrenal tumors and cyst. Key words: Laparoendoscopic single site surgery; Adrenalectomy; Adrenal gland neoplasms; Intraoperative period