title: Early experience with laparoscopic approach for adrenalectomy.
abstract: BACKGROUND
  Adrenalectomy performed by a posterior or transabdominal approach causes substantial postoperative pain. The purpose of this study was to evaluate laparoscopy as a potential approach for adrenalectomy.
  
  
  METHODS
  We performed 25 consecutive laparoscopic adrenalectomies on 22 patients from April 1, 1992, to March 30, 1993. Laparoscopic surgery was performed by using a lateral decubitus flank approach with four 11 mm trocars.
  
  
  RESULTS
  Twelve right and 13 left adrenal glands were removed in a mean time of 2.3 hours. Three patients underwent bilateral adrenalectomies in a mean time of 5.3 hours. The 15 women and 7 men range in age from 31 to 60 years (mean, 42 years). The adrenal gland diseases were nonfunctional adenoma (seven), pheochromocytoma (five), Cushing's disease (four), Cushing's adenoma (four), primary aldosteronism (two), dehydroepiandrostenedione sulfate hypersecretion (one), angiomyolipoma (one), and medullary cyst (one). Average tumor size was 4.1 cm (range, 1 to 15 cm). Laparoscopic adrenalectomy was successful in 96% of patients, with one patient requiring a laparotomy because of inadequate exposure. The median postoperative stay was 4 days (range, 2 to 19), with a mean of five narcotic injections. There were no deaths, and morbidity was minor.
  
  
  CONCLUSIONS
  Laparoscopy can be used successfully for adrenalectomy. It produces less postoperative pain and rapid return to normal activity. It may be the preferred method for removing most adrenal gland lesions that require operation.
authors.affiliation: Department of Surgery, Hôtel-Dieu de Montréal, University of Montreal, Quebec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Gagner
authors.forename: A
authors.initials: A
authors.lastname: Lacroix
authors.forename: R A
authors.initials: RA
authors.lastname: Prinz
authors.forename: E
authors.initials: E
authors.lastname: Bolté
authors.forename: D
authors.initials: D
authors.lastname: Albala
authors.forename: C
authors.initials: C
authors.lastname: Potvin
authors.forename: P
authors.initials: P
authors.lastname: Hamet
authors.forename: O
authors.initials: O
authors.lastname: Kuchel
authors.forename: S
authors.initials: S
authors.lastname: Quérin
authors.forename: A
authors.initials: A
authors.lastname: Pomp
mesh_terms: D000307:Adrenal Gland Diseases / Q000473:pathology / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation