title: Single-incision transperitoneal laparoscopic left adrenalectomy.
abstract: BACKGROUND
  Laparoscopic adrenalectomy via three or four trocars is a well-established procedure. This report describes the initial experience with single-incision laparoscopic surgery (SILS) using the transperitoneal approach for left adrenalectomy.
  
  
  METHODS
  Between April 2010 and August 2011, all consecutive patients with adrenal masses, including Conn's syndrome, Cushing's adenoma, and nonfunctional adrenal tumors, who agreed to undergo SILS adrenalectomy were included in a prospective study. The left 2.5-cm subcostal incision was the sole point of entry. Data of patients who underwent SILS adrenalectomy were compared with those from an uncontrolled group of patients who underwent conventional laparoscopic adrenalectomy during the same study period.
  
  
  RESULTS
  There were 20 patients in each study group (20 men, 20 women; mean age [SD] = 50 [6.5] years). SILS was successfully performed and none of the patients required conversion to an open procedure. In one case of SILS procedure, an additional lateral 5-mm port was needed for retraction of the kidney. The mean (SD) duration of the operation was 95 (20) min in the SILS group and 80 (8) min in the conventional laparoscopic adrenalectomy group (p = 0.052). There were no intraoperative or postoperative complications. There were no differences between the two study groups with respect to postoperative pain, number of patients who resumed oral intake within the first 24 h, final pathologic diagnosis, and length of hospital stay.
  
  
  CONCLUSIONS
  SILS left adrenalectomy is a technically feasible and safe procedure in carefully selected patients. The definitive clinical, aesthetic and functional advantages of this technique require further analysis.
authors.affiliation: General and Endocrine Surgery Unit, Department of General and Digestive Surgery, Digestive Diseases and Metabolism Institute, Hospital Clínic i Provincial, Universitat de Barcelona, CIRBERHED, IDIBAPS, Villarroel 170, 08036 Barcelona, Spain. ovidal@clinic.ub.es
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Vidal
authors.forename: Emiliano
authors.initials: E
authors.lastname: Astudillo
authors.forename: Mauro
authors.initials: M
authors.lastname: Valentini
authors.forename: Cesar
authors.initials: C
authors.lastname: Ginestà
authors.forename: Juan C
authors.initials: JC
authors.lastname: García-Valdecasas
authors.forename: Laureano
authors.initials: L
authors.lastname: Fernandez-Cruz
mesh_terms: D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome