[Gas-free lateral retroperitoneoscopy from an open mini-approach for adrenalectomy]

The aim of the study was assessment of efficacy of gas-free lateral retroperitoneoscopy from the open mini-approach for adrenalectomy. Arguments are given for location of the mini-cut in the anterior segment of the 10th intercostal space and analysis was made of operative space parameters in retroperitoneoscopy from open mini-approach. The wound aperture 5.0 cm in size and 15.0 cm in depth is good as it provides the diameter of the monofocal zone 16.0 cm and bifocal zone 4.0 cm. If the size of the wound increases to 7.0 cm, the above parameters rise to 20.0 and 7.9 cm, respectively. Such visualized space is sufficient for adrenalectomy. Variants of the intervention are proposed depending on the side and kind of the lesion. A total of 21 patients with various adrenal pathology were operated. The operation lasted for 114.7 +/- 1.5 min. Overall blood loss reached 22.0 +/- 3.2 ml, transfusion--137.8 +/- 1.0 ml. The intestinal function normalized on day 1-2. In the postoperative period mean number of narcotic analgetics injections made up 4.9 +/- 1.5. Body temperature returned to normal on day 5.3 +/- 1.6 after the intervention. The length of the scar was 4.2 +/- 0.6 cm. None lethal cases were registered. Conversion to the classic open procedure had to be made in four cases. Gas-free lateral retroperitoneoscopic adrenalectomy from open mini-approach is minimally invasive operation. In well selected cases this is a safe and effective alternative to conventional and endovideoscopic gas surgery.