Transperitoneal laparoscopic adrenalectomy: outline of the preoperative management, surgical approach, and outcome.
The laparoscopic approach to the adrenal gland has evolved to be the gold standard for most cases of adrenal conditions requiring surgical treatment. There is general consent about the safety, efficacy, and reproducibility of laparoscopic adrenal surgery. Compared to the open surgery, significant advantages with regard to shorter hospitalization time, decreased postoperative morbidity, improved cosmetics, and quicker convalescence are evident. The anatomic location of the adrenal gland led to the development of various approaches, including lateral transperitoneal, anterior transperitoneal, lateral retroperitoneal, posterior retroperitoneal, and even transthoracic approaches. The lateral transperitoneal approach is the technique most frequently used for laparoscopic adrenalectomy. A large operative field provides good orientation and visualization of familiar landmarks known from open surgery. In particular in the early learning curve this represents an advantage of the transperitoneal laparoscopic approach. This article describes in detail the indications, contraindications, preoperative evaluation, surgical technique, management of intraoperative complications, and outcome after lateral transperitoneal adrenalectomy.
Department of Urology, University Clinic Eppendorf, Martinistrasse 52, 20246 Hamburg. Germany.
Mario
M
Zacharias
Alexander
A
Haese
Andreas
A
Jurczok
Jens-Uwe
JU
Stolzenburg
Paolo
P
Fornara
D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010529:Peritoneal Cavity; D012187:Retroperitoneal Space