title: Single-port laparoscopic left adrenalectomy (SILS): 3 years' experience of a single institution.
abstract: BACKGROUND
  Laparoscopic adrenalectomy by 3 or 4 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 January 2013, all consecutive patients with adrenal masses 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 undergoing SILS adrenalectomy were compared with those from an uncontrolled group of patients undergoing conventional laparoscopic adrenalectomy during the same study period.
  
  
  RESULTS
  There were 40 patients in each study group. SILS was successfully performed and none of the patients required conversion to an open procedure. In 1 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 80 (20) minutes in the SILS group and 75 (8) minutes in the conventional laparoscopic adrenalectomy group (P=0.150). No intraoperative or postoperative complications occurred. Differences between the 2 study groups in postoperative pain, number of patients resuming oral intake within the first 24 hours, final pathologic diagnosis (Conn syndrome, Cushing adenomas, nonfunctioning adrenal tumors), and length of hospital stay were not observed.
  
  
  CONCLUSIONS
  SILS left adrenalectomy is a technically feasible and safe procedure in carefully selected patients and seems to have results similar to a conventional approach in our initial comparison.
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, Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
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: Ginestá
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Espert
authors.forename: Juan C
authors.initials: JC
authors.lastname: Gracía-Valdecasas
authors.forename: Laureano
authors.initials: L
authors.lastname: Fernández-Cruz
mesh_terms: D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011446:Prospective Studies; D013997:Time Factors