Single-port endoscopic retroperitoneal adrenalectomy: initial experience

Abstract

Over the last decade, laparoendoscopic adrenalectomy has become the standard of care for adrenal removal. Elimination of a large incision and difficult exposure has decreased postoperative morbidity and length of stay. Single port access (SPA) surgery was developed as an alternative to traditional multi-port laparoscopy, potentially exploiting the already proven benefits of minimally invasive surgery. We applied the SPA technique to adrenalectomy using the posterior retroperitoneal approach. Between January 2010 and July 2010, a 52-year-old female with Conn’s adenoma and two females, aged 31 and 39, both diagnosed with pheochromocytoma, underwent single port endoscopic retroperitoneal adrenalectomies. Procedures were performed using two different commercially available specific access devices and conventional laparoscopic equipment. No conversions to open or conventional retroperitoneal approach were necessary. No perioperative or postoperative complications occurred. Operating time ranged from 120 min to 240 min. All patients were discharged from the hospital 2 days after surgery. The single port access technique has been successfully applied to adrenalectomy as an available alternative to multiport laparoendoscopic adrenalectomy. Exposure, visualization, and dissection are the same as in retroperitoneal endoscopic adrenalectomy. Single port access surgery offers the patient benefits such as faster convalescence, decreased postoperative scarring and better cosmetic effect.