Endoscopic retroperitoneal adrenalectomy

Aim of study: To determine prospectively in consecutive patients the value of Patients and methods: Between March 1994 and March 1995, endoscopic adrenalectomy via a retroperitoneal approach was performed in eleven patients (three men, eight women; median age 61 [48-73] years), unilateral in nine, bilateral in two. The procedure was indicated if the adrenal tumour was thought to be benign and no larger than 5 cm in diameter (two adrenal and two central Cushing's syndromes; three incidentally detected adrenal adenomas, two phaeochromocytomas, two Conn adenomas). Results: Twelve of the 13 procedures were successfully performed. In one case the primary incision in the mid-axillary line had been too large and no satisfactory pneumoretroperitoneum was achieved. Median duration of operation was 180 (125-330) min, and the intraoperative blood loss was 200 (125 - 330) ml. There were no postoperative complications and the median postoperative hospital stay was 6 days (3-12). Conclusion: In small (up to 5 cm) adrenal tumours not suspected to be malignant the endoscopic retroperitoneal approach constitutes a sparing alternative to the conventional access to the adrenal gland.