Laparoscopic adrenal surgery: new frontiers.
After about 10 years of experience, laparoscopic adrenalectomy has become the gold standard for the treatment of adrenal lesions. Here, we describe the presenting features, imaging methods, and current surgical approaches to diseases of the adrenal gland. There is general agreement on the suitability of the laparoscopic approach for benign adrenal lesions, but controversy exists about using laparoscopy for suspected adrenal malignancy, metastasis, and partial adrenalectomy. This article reviews the literature on laparoscopic adrenalectomy. In particular, we focus our attention on the new surgical approaches to the gland. We evaluate the indications, operative techniques, and tools for partial adrenalectomy, and we discuss new surgical strategies such as cryosurgery and radiofrequency ablation.
Micali
Salvatore
S
Department of Urology, University of Modena, Via del Pozzo 71, 41100 Modena, Italy. micali.salvatore@unimo.it
Peluso
G
G
De Stefani
S
S
Celia
A
A
Sighinolfi
M C
MC
Grande
M
M
Bianchi
G
G
D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis / Q000601:surgery; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D003480:Cushing Syndrome / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010673:Pheochromocytoma / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome