Laparoscopic adrenalectomy for benign adrenal neoplasms

Background: Since first reported in 1992, laparoscopic adrenalectomy has been used to remove a wide variety of adrenal neoplasms. Indications for use of this technique have not been clearly defined, nor has it been demonstrated to be more cost effective than open adrenalectomy. Methods: A retrospective comparison was made of 19 consecutive laparoscopic and open adrenalectomies performed in patients with benign adrenal neoplasms in a tertiary-care university teaching hospital over a 3-year period. Results: The two groups were well matched for side of tumor and age. Laparoscopic adrenalectomy was completed in 11 of 12 patients in whom it was attempted. The laparoscopic group had significantly smaller tumor size; shorter operative time, postoperative ileus, and postoperative stay; and decreased operative blood loss and postoperative narcotic requirement. There were no significant differences between groups for operating room or hospital charges. Conclusions: Laparoscopic adrenalectomy is cost effective and should be the preferred treatment for patients with small benign adrenal neoplasms.