Transperitoneal Laparoscopic Adrenalectomy: Outline of the Preoperative Management, Surgical Approach, and Outcome

The laparoscopic approach to the adrenal gland has evolved to be the gold standard for most cases of adrenal conditions requiring surgical treatment. There is general consent about the safety, efficacy, and reproducibility of laparoscopic adrenal surgery. Compared to the open surgery, significant ad...

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Bibliographic Details
Published in:European urology 2006-03, Vol.49 (3), p.448-459
Main Authors: Zacharias, Mario, Haese, Alexander, Jurczok, Andreas, Stolzenburg, Jens-Uwe, Fornara, Paolo
Format: Article
Language:English
Subjects:
Adrenal gland
Adrenal Gland Diseases - diagnosis
Adrenal Gland Diseases - pathology
Adrenal Gland Diseases - surgery
Adrenalectomy
Adrenalectomy - methods
Aged
Biological and medical sciences
Female
Humans
Laparoscopy
Laparoscopy - methods
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Perioperative Care
Peritoneal Cavity
Retroperitoneal Space
Surgical technique
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Summary:The laparoscopic approach to the adrenal gland has evolved to be the gold standard for most cases of adrenal conditions requiring surgical treatment. There is general consent about the safety, efficacy, and reproducibility of laparoscopic adrenal surgery. Compared to the open surgery, significant advantages with regard to shorter hospitalization time, decreased postoperative morbidity, improved cosmetics, and quicker convalescence are evident. The anatomic location of the adrenal gland led to the development of various approaches, including lateral transperitoneal, anterior transperitoneal, lateral retroperitoneal, posterior retroperitoneal, and even transthoracic approaches. The lateral transperitoneal approach is the technique most frequently used for laparoscopic adrenalectomy. A large operative field provides good orientation and visualization of familiar landmarks known from open surgery. In particular in the early learning curve this represents an advantage of the transperitoneal laparoscopic approach. This article describes in detail the indications, contraindications, preoperative evaluation, surgical technique, management of intraoperative complications, and outcome after lateral transperitoneal adrenalectomy.
ISSN:0302-2838
1873-7560
DOI:10.1016/j.eururo.2006.01.014