title: Laparoendoscopic single site (LESS) adrenalectomy: technique and outcomes.
abstract: OBJECTIVE
  To describe the surgical technique, to analyze outcomes and to provide an overview of the current status of laparoendoscopic single site (LESS) adrenalectomy.
  
  
  METHODS
  A comprehensive PubMed search was performed for all relevant urological literature regarding LESS and adrenal surgery. In addition, experience gained at the authors' own institutions was considered. Clinical descriptive and comparative reports on LESS adrenal surgery procedures were analysed.
  
  
  RESULTS
  LESS adrenal surgery has been effectively performed for a number of indications. A wide variety of approaches (transperitoneal versus retroperitoneal, multichannel trocar versus multiple ports, trans- or extraumbilical) have been described. LESS adrenalectomy seems to be safe, taking more time than the standard laparoscopic counterpart but appears to offer the patient less postoperative discomfort. Technical difficulties of the procedure include the requirement of more time for adjustment of articulating instruments, longer 'one-handed' manipulation time, and a high peroperative tissue re-grasping rate.
  
  
  CONCLUSIONS
  The feasibility and safety of LESS adrenalectomy has been demonstrated. Only long-term follow-up outcomes will prove its benefits over conventional laparoscopy and define the role and the oncological safety of LESS adrenal surgery.
authors.affiliation: Department of Urology, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH, UK. a.rane@btinternet.com
authors.forename: Abhay
authors.initials: A
authors.lastname: Rane
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Luigi
authors.initials: L
authors.lastname: Schips
authors.forename: Marco
authors.initials: M
authors.lastname: De Sio
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods* / Q000639:trends; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000639:trends; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome