title: Adrenalectomy by retroperitoneal laparoendoscopic single site surgery.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is the current standard for treatment of benign adrenal disease. To reduce the invasiveness of surgery, new techniques have been recently proposed, such as mini-laparoscopy, natural orifice transluminal endoscopic surgery, and laparoendoscopic single site surgery (LESS). Herein, we describe one case of adrenalectomy by retroperitoneal LESS using conventional laparoscopic instruments and ports.
  
  
  METHODS
  A 52-year-old female patient with an incidental finding of a 3-cm mass in the left adrenal was referred to us. Preoperative blood concentrations of catecholamines, aldosterone, and cortisol, and urinary excretion of vanilmandelic acid were normal. She underwent an adrenalectomy by retroperitoneal LESS using conventional instruments and ports. Operative time and estimated blood loss were 82 minutes and ≤50cc, respectively. She was discharged 12 hours after surgery. No intra- or postoperative complications occurred. Pathological analysis of the specimen identified an adrenal cortical adenoma.
  
  
  CONCLUSIONS
  Adrenalectomy by retroperitoneal LESS using conventional laparoscopic instruments is feasible. Further studies must be performed to evaluate safety, indications and benefits of this approach.
authors: Department of Urology, Cruz Vermelha Hospital, Curitiba, Paraná, Brazil.
authors: Anibal Wood
authors: AW
authors: Branco
authors: William
authors: W
authors: Kondo
authors: Luciano Carneiro
authors: LC
authors: Stunitz
authors: Saturnino Ribeiro do Nascimento
authors: SR
authors: Neto
authors: Carolina Cortese Ribeiro do
authors: CC
authors: Nascimento
authors: Alcides José Branco
authors: AJ
authors: Filho
references: World J Surg. 1999 Apr;23(4):389-96
references: 10030863
references: Transplantation. 2004 Feb 27;77(4):521-5
references: 15084928
references: Eur Urol. 2008 Jun;53(6):1117-20
references: 18304726
references: Arch Surg. 2007 Sep;142(9):823-6; discussion 826-7
references: 17875836
references: Urology. 1998 Aug;52(2):180-6
references: 9697779
references: Urology. 2008 Jan;71(1):3-6
references: 18242353
references: BJU Int. 2008 Jan;101(1):83-8
references: 18086101
references: J Laparoendosc Adv Surg Tech A. 2009 Feb;19(1):59-61
references: 19196085
references: BJU Int. 2009 Oct;104(8):1136-42
references: 19338528
references: N Engl J Med. 1992 Oct 1;327(14):1033
references: 1387700
references: Surg Endosc. 2002 Jan;16(1):96-9
references: 11961614
references: Eur Urol. 2008 Nov;54(5):1020-9
references: 18640774
references: Arch Surg. 1996 Aug;131(8):870-5; discussion 875-6
references: 8712912
references: Urology. 2004 May;63(5):857-61
references: 15134965
references: Surg Laparosc Endosc. 1998 Jun;8(3):171-9
references: 9649038
references: Surg Endosc. 2001 Nov;15(11):1356-8
references: 11727150
references: Ann Surg. 1997 Sep;226(3):238-46; discussion 246-7
references: 9339930
references: Transplantation. 2004 Jul 15;78(1):168-71
references: 15257059
references: Surg Endosc. 2009 Jun;23(6):1390
references: 19263136
references: Urology. 2007 Dec;70(6):1039-42
references: 18158008
references: J Laparoendosc Adv Surg Tech A. 2004 Feb;14(1):23-6
references: 15035840
references: J Urol. 2002 Jan;167(1):238-41
references: 11743316
references: Langenbecks Arch Surg. 2009 May;394(3):447-50
references: 18784938
references: Eur Urol. 2008 Jun;53(6):1290-4
references: 17997020
references: Cleve Clin J Med. 2006 Jun;73(6):561-8
references: 16784156
references: J Laparoendosc Adv Surg Tech A. 2001 Dec;11(6):409-13
references: 11814133
references: J Urol. 2008 Aug;180(2):637-41; discussion 641
references: 18554653
references: Surg Endosc. 1996 Oct;10(10):987-90
references: 8864091