title: Laparoscopic adrenalectomy - a review of initial 24 consecutive patients.
abstract: OBJECTIVE
  To analyze patient demographics, pathology, surgical procedure and outcome in initial 24 consecutive patients who underwent laparoscopic adrenalectomy in our department.
  
  
  METHODS
  Twenty four patients underwent laparoscopic adrenalectomy between September 2000 and August 2005. There were 12 males and 12 females with a mean age of 44.6 years (range 25-68 years). The indications for adrenalectomy were pheochromocytoma (13 patients), Cushing's syndrome (5 patients), myelolipoma (2 patients), adrenal cyst (2 patients), aldosteronoma (1 patient) and adrenal incidentaloma (1 patient). Nineteen of our patients with functioning adrenal tumours were prepared preoperatively for periods ranging up to 2 weeks by the endocrinologist. All laparoscopic adrenalectomies were performed via lateral transperitoneal approach using standard four-port technique. Patients with pheochromocytoma and Cushing's syndrome were monitored in the surgical intensive care unit during immediate postoperative period. The clinical and intraoperative characteristics, complications and outcomes of all patients were analyzed.
  
  
  RESULTS
  The mean operative time for laparoscopic adrenalectomy was 136 minutes. Intraoperative hypertension occurred in 8 patients. Intraoperative hypotension occurred in 2 patients. One patient required conversion due to dense adhesions and hemorrhage. Postoperative complications were seen in six patients - immediate postoperative hypotension (2 patients), features of steroid withdrawal (2 patients) and postoperative pyrexia (2 patients). Five patients with pheochromocytoma required antihypertensive drugs in the postoperative period. There was no mortality in our series.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy is a safe operation that incorporates all the benefits of minimal access surgery and is associated with a satisfactory postoperative outcome. A careful preoperative preparation in functioning adrenal tumours aids in the faster recovery of these patients.
authors.affiliation: Consultant Surgeon Minimal Access and Bariatric Surgery Center, Sir Ganga Ram Hospital, Room No. 200 (IInd floor), New Delhi, 110 060 India.
authors.forename: R
authors.initials: R
authors.lastname: Venkatasubramanian
authors.forename: Atul
authors.initials: A
authors.lastname: Wadhwa
authors.forename: Anil
authors.initials: A
authors.lastname: Sharma
authors.forename: Rajesh
authors.initials: R
authors.lastname: Khullar
authors.forename: Vandana
authors.initials: V
authors.lastname: Soni
authors.forename: Manish
authors.initials: M
authors.lastname: Baijal
authors.forename: P K
authors.initials: PK
authors.lastname: Chowbey
keywords: Adrenalectomy; Laparoscopy; Pheochromocytoma