[Laparoscopic adrenalectomy. A critical review of the literature]

Open adrenalectomy needs surgical incisions often large and traumatic, with a not negligible morbidity. Laparoscopic adrenalectomy, according to the experiences reported in the literature, certainly initial, but nevertheless considerable, seems to offer a sound option and will probably become one of the strongest indications of the minimal-access surgery of the retroperitoneal space. Operative times are certainly longer initially than in open surgery but morbidity is very low and mortality almost nil. The authors make a review of the literature about laparoscopic adrenalectomy with about 400 operations collected, analyzing the results and the technical details. The collected data support the conclusion that the adrenal pathology, with the exception of the malignant tumors, will be treated in the future mainly laparoscopically. Even the size of the tumor, in case of a not malignant mass, can not be considered probably a true contraindication.