Transperitoneal laparoscopic adrenalectomy: five years' experience with 35 patients

Objective: To present our laparoscopic surgery experience in the treatment of adrenal masses.

Material and methods: Between January 2008 and February 2013, a total of 35 patients (24 females, 11 males) underwent transperitoneal laparoscopic adrenalectomy to treat an adrenal mass. The patients underwent hormonal evaluation, chemical shift magnetic resonance imaging, or abdominal computerized tomography. Twenty-seven patients (77.1%) had a hormone-active adrenal mass.

Results: Eighteen right, 16 left, and one bilateral transperitoneal laparoscopic adrenalectomies were performed. The mean age and body mass index of the patients were 47.4 years and 26.6 kg/m2, respectively. The mean adrenal mass size, operation time, estimated blood loss, and hospitalization duration were 41.9 mm, 94.7 min, 30 cc, and 2.4 d, respectively. No minor or major complications were observed perioperatively or postoperatively. In 1 patient (2.8%), the laparoscopic approach was converted to open surgery due to severe bradycardia resulting from chronic obstructive pulmonary disease. Histopathological examinations revealed adrenocortical hyperplasia in 23 (66%) patients, benign pheochromocytoma in 8 (22.8%) patients, and periadrenal paraganglioma, adrenocortical carcinoma, myeloid metaplasia, and myelolipoma in 1 (2.8%) patient each.

Conclusion: Transperitoneal laparoscopic adrenalectomy is a safe and efficient minimally invasive treatment option with a low morbidity rate in the surgical treatment of adrenal masses.