Experience with retroperitoneal laparoscopic adrenalectomy in 115 procedures

Purpose: Laparoscopic adrenalectomy has become an effective option for removing small adrenal tumors. We evaluated the retroperitoneal approach with regard to operative complications, morbidity and hospital stay. Materials and Methods: Between January 1995 and March 2000 we performed a total of 115 laparoscopic adrenalectomies via the retroperitoneal approach, including 70 on the left and 45 on the right, side, in 64 women and 42 men 17 to 74 years old (mean age 49.3) with adrenal neoplstsms. Average adrenal tumor size was 31 mm. (range 10 to 65). All procedures required 4 trocars and mean operative time was 118 minutes (range 45 to 240). Results: There were no patient deaths. The conversion rate to open surgery was 0.8% and estimated blood loss was 77 ml. (range 0 to 550). At a mean followup of 23.4 months, morbidity was 15.5% with intraoperative vascular injury in 3 cases (3.4%) and postoperative complications in 12.1%, including wound infection, deep hematoma, parietal dehiscence and severe pneumopathy, Average hospital stay was 4 days and mean duration of analgesic requirement was 2 days (range 1 to 5). Conclusions: The retroperitoneal approach to laparoscopic adrenalectomy appears to be minimally invasive and safe for adrenal tumors not larger than 5 cm.