Laparoscopic adrenalectomy

Abstract

Laparoscopic adrenalectomy was introduced as an alternative, potentially less morbid technique for adrenalectomy some 10 years ago. As the procedure and its indications are now mature, a review of the advantages/disadvantages and indications of the technique will place its role in firm context.

The anticipated advantages for the patient of lessened postoperative morbidity have been realized, especially for those undergoing surgery for cortisol-producing adrenal tumors. Controversy remains as to whether the laparoscopic technique might represent a disadvantage for patients with pheochromocytoma or potential adrenocortical carcinoma, due to the limited ability to achieve wide resection margins with laparoscopy in every case.

Laparoscopic adrenalectomy is the approach of choice in patients undergoing surgery for aldosteronoma, cortical-producing adenomas, adrenal cyst, and myelipoma. The approach should be considered carefully for patients with pheochromocytoma and adrenocortical trophic hormone-dependent adrenal hyperplasia. Laparoscopy is not recommended for suspected or known adrenal malignancies.