Difficulties in Laparoscopic Adrenalectomy
Laparoscopic adrenalectomy is the method of choice in the majority of adrenal lesions. The open surgical approach for adrenal lesions requires a long skin incision, which at times may require muscle and rib cutting. The laparoscopic approach is quick and safe, the magnification offers excellent visibility, and blood loss is substantially decreased if the surgical technique is meticulous. Adrenalectomy is also one of the few laparoscopic procedures in which, due to the quick access to the area in question, has a shorter operative time. Although there is general agreement on use of this approach for benign and small lesions, the issue of the laparoscopic approach in adrenocortical carcinomas remains unresolved. This chapter discusses operative technique and troubleshooting measures.
- 3.Chow GK, Blute ML. Surgery of the adrenal gland. In: Wein, Kavoussi, Novick, Partin, Peters, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders; 2007:1869.Google Scholar
- 10.Miller BS, Ammori JB, Ganger PG, Broome JT, Hammer GD, Doherty GM. Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma. [published online ahead of print April 7, 2010] World J Surg. doi: 10.1007/s00268-010-0532-2.
- 13.National Institutes of Health. NIH state-of-the-science-statement on management of clinically inapparent adrenal mass (“incidentaloma”). NIH Consens State Sci Statements. 2002;19(2):1-25.Google Scholar
- 14.Sharma R, Ganpule A, Veermani M, Sabnis RB, Desai M. Laparoscopic management of adrenal lesions larger than 5 cm in diameter. Urol. J 2009;6(4):254-259.Google Scholar