The experience of retroperitoneal laparoscopic adrenal surgery via intra-adipose capsule approach

Abstract

Objective To investigate the safety and feasibility of retroperitoneal laparoscopic adrenal surgery via intra-adipose capsule approach. Methods From Jan. 1st, 2015 to Dec. 30th, 2018, a total of 252 patients with adrenal tumors were admitted and treated with adrenal surgery. Among them, 115 patients underwent transperitoneal laparoscopic adrenal surgery, while 137 patients underwent retroperitoneal laparoscopic adrenal surgery through intra-adipose capsule approach. The method of retroperitoneal laparoscopic adrenal surgery through intra-adipose capsule approach was as followed: after the retroperitoneal working space was established routinely and Gerota fascia was dissected, adrenal glands were sought directly at the non-vascular layer between the upper portion of the kidney and the adipose capsule, then total adrenalectomy or partial adrenalectomy were selected. The operation time, intraoperative blood loss, postoperative hospitalization, and complications were analyzed. Results All of the 252 cases of operation were succeeded, with no case transferred to open operation, nor received intraoperative or postoperative blood transfusion treatment. For the transperitoneal laparoscopic adrenal surgery group vs retroperitoneal laparoscopic adrenal surgery through intra-adipose capsule approach group, the operation time was (52.7±19.7) min vs (54.4±22.7) min, with no statistical significance; Intraoperative blood loss was (33.1±23.2) ml vs (31.8±21.4) ml, with no statistical significance; The postoperative hospitalization time was (3.5±0.9) d vs (2.8±0.4) d, with retroperitoneal group was shorter significantly. Conclusions Retroperitoneal laparoscopic adrenal surgery through the intra-adipose capsule approach is a safe and feasible surgical method. It can simplify the surgical procedure and promote the recovery of the patients. Key words: Retroperitoneal laparoscope; Adrenal surgery; Intra-adipose capsule