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Minimal access adrenal surgery

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Abstract

Laparoscopic adrenalectomy has become the preferred method for removal of most adrenal tumors. An important component in selecting patients for this operation is to understand the clinical presentation and diagnostic workup for the various functioning and nonfunctioning adrenal tumors. In this review, an overview of the key clinical and diagnostic aspects of the most common adrenal tumors is presented. The indications and contraindications for a laparoscopic approach are discussed and the technique for laparoscopic adrenalectomy is then presented with inclusion of video links to demonstrate the technique. A review of the results of laparoscopic adrenalectomy is then considered with regard to common outcome measures and complications. A current controversy in adrenal surgery is the role of laparoscopic adrenalectomy in the management of patients with large tumors and malignant or potentially malignant adrenal lesions and the literature on this topic is reviewed in detail. The article concludes with a discussion of the indications and technique for partial adrenalectomy.

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Acknowledgments

The author thanks Peggy Frisella, RN, and Mary Quasebarth, RN, for their assistance in preparing the video sequences shown in the multimedia adrenalectomy video presentation.

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  1. Department of Surgery, Institute for Minimally Invasive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, St. Louis, MO, 63110, USA

    L. M. Brunt

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  1. L. M. Brunt
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Correspondence to L. M. Brunt.

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Brunt, L.M. Minimal access adrenal surgery. Surg Endosc 20, 351–361 (2006). https://doi.org/10.1007/s00464-004-8269-3

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