Posterior retroperitoneoscopic adrenalectomy—Case series

• Published in: International journal of surgery case reports 2018-01, Vol.51, p.174-177
• Main Authors: Costa Almeida, Carlos E., Caroço, Teresa, Silva, Marta A., Albano, Miguel N., Louro, João M., Carvalho, Luis F., Costa Almeida, Carlos M.
• Format: Article
• Language: English
• Subjects: Adrenal; Adrenalectomy; Minimal invasive surgery; Posterior; Retroperitoneoscopic
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2018.08.044

•Posterior retroperitoneoscopic (PR) technique has advantages over transperitoneal approach.•Many surgeons keep using laparoscopy because they are more confident when working in the wider peritoneal space.•Posterior retroperitoneoscopy is feasible and safe, and avoids bowel injury.•PR adrenalectomy has a small learning curve. Posterior retroperitoneoscopic adrenalectomy has advantages over transperitoneal technique. However many surgeons prefer the transperitoneal technique because they get a familiar and wider working space. A retrospective analysis of the first 10 patients submitted to posterior retroperitoneoscopic adrenalectomy was conducted. Data collected included: diagnosis, size, operation time, blood loss, conversion rate, morbidity and mortality, in-hospital length of stay. Compare our outcomes with worldwide bigger series, and take conclusions on the feasibility of the technique was the objective. We included 2 pheochromocytomas, 1 giant cystic pheochromocytoma, 4 Conn’s, 2 Cushing’s, 1 non-functioning tumor with 4 cm. Mean operation time was 46,7 min for lesions ranging from 1,8 to 14 cm. Blood loss was negligible. One patient (10%) was converted to laparotomy because of a past clinical history of dorsal and lumbar trauma. No morbidity and no mortality. Mean hospital length of stay was 2,2 days. Mean operation time found in bigger series published in worldwide literature is 40–105,6 min. Complication rate reported ranges from 0 to 14,4%. No mortality has been ever reported. Blood loss reported in other series is 10–50 ml. The data found in our study matches other studies data. Since the same surgeon who had never performed the technique before operated all patients, makes us believe the technique is safe and feasible. Posterior retroperitoneoscopic adrenalectomy has a small learning curve. It is technically safe and feasible. More patients will be collected to validate these results.