Posterior Retroperitoneoscopy As a New Minimal Invasive Approach to Adrenalectomy

L.Varga, Z. Hódi, Gy. Lázár jr., J. Julesz, M. K. Walz, A. Balogh

Abstract

A total of 21 adrenalectomies were performed from a posterior (lumbotomy) approach, using a minimally invasive retroperitoneoscopic technique. The "UltraCision" scalpel, an ultrasound-activated cutting-coagulating device was used for operative tissue dissection. Two cases were converted: the mean operating time in the 19 successful cases was 128 minutes. No mortality and no septic complications occurred. and the mean operative blood loss in the 18 procedures was less than 100 ml. The mean duration of hospitalization was 3-5 days, and complete recovery took 2-3 weeks. From our experience and the findings of prospective, randomized clinical studies in the literature retroperitoneoscopic adrenalectomy from a posterior approach can be recommended for the surgical treatment of benign tumours of the suprarenal gland that are less than 5 cm in diameter. The low conversion and complication rates, the minimal operative blood loss, the short period of hospitalization and the short recovery time are all advantages of this method. It can be performed after previous abdominal operation and in cases involving morbid obesity. The technique is suitable for bilateral adrenalectomies, but is not justified for the removal of adrenal tumours that are malignant and/or larger than 6 cm. Coagulopathies are contraindications.

Key words

Minimally invasive surgery - retroperitoneoscopy - adrenalectomy - retroperitoneoscopic adrenalectomy from a posterior approachtc