Laparoscopic adrenalectomy: Transperitoneal lateral approach. Cases study

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Vincenzo Neri, Antonio Ambrosi, Alberto Fersini, Tiziano Pio Valentino

Ann. Ital. Chir., 2005; 76: 123-126

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AIM OF THE STUDY: To compare the results of the laparoscopic adrenalectomy achieved with the traditional laparotomic
one.
MATERIAL AND METHOD: In the period 1997-September 2004 we treated 17 patients with adrenal pathology: eight
patients underwent to an open anterior transperitoneal adrenalectomy and nine patients underwent a laparoscopic adrenalectomy
with lateral transperitoneal approach.
RESULTS: Among the immediate results a longer operative time was evident in the laparoscopic approach and a greater
blood loss in the open approach; there were no conversions to a laparotomic procedure. In the postoperative period there
were some bronchopneumonic infiltrates and some infections of the laparotomy in the open group; in the laparoscopic
group there was a parietal haematomas that cleared up spontaneously, in correspondence of a trocar access.
DISCUSSION: Both procedures allow to achieve the complete resolution of the adrenal pathology if it is confined within
the gland and no more than 8 cm. in size.
The morbidity in the mininvasive approach is surely much lower than the open technique. The advantages of a laparoscopic
approach can be found in a minor surgical stress. The evident datum that results from the literature analysis
of the results of the the laparoscopic adrenalectomies, is the very rapid resumption of the normal activities in the postoperative
course.
CONCLUSIONS: The laparoscopic adrenalectomy with lateral transperitoneal approach is a safe and efficacious procedure.
Therefore, the AA can believe that the laparoscopic approach is at present the gold standard in the treatment of all benign
adrenal pathologies with a no more than 8 cm. size.

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