Laparoscopic Adrenalectomy

Adrenal pathology requiring surgical intervention is relatively uncommon. Nevertheless, there are a number of conditions that warrant such consideration. Most surgically correctable diseases of the adrenal glands are associated with excess production of adrenal corticosteroids or catecholamines by an adrenal tumor. Classic open approaches toward adrenalectomy in the past have included an anterior, transabdominal, or posterior route. Laparoscopic adrenalectomy offers the advantages of excellent exposure through minimally damaging portals. This results in an expected very benign postoperative course. It has now been almost 4 years since the first reported laparoscopic adrenalectomy. Since then, numerous small series have been reported and experienced laparoscopic surgeons have proven the merits of a laparoscopic approach to adrenalectomy. This reviews the current state of the art and offers descriptions of selected approaches to both the right and left adrenal glands.