[Abdominal preoperation. No contraindication for laparoscopic transabdominal adrenalectomy]

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Endocrinology

Background:

• Benign adrenal gland tumors <6 cm are indications for minimally invasive surgery.
• Previous studies show no significant difference between retroperitoneoscopic and transabdominal adrenalectomy.
• Intestinal adhesions may contraindicate transabdominal laparoscopic adrenalectomy, favoring retroperitoneoscopic approach.

Purpose of the Study:

• To evaluate the safety and efficacy of transabdominal laparoscopic adrenalectomy in patients with and without prior abdominal surgery.
• To determine if prior abdominal surgery impacts conversion rates to open surgery.
• To compare operating times and outcomes between the two groups.

Main Methods:

• Prospective study of 114 adrenalectomies over 5 years.
• Comparison of patients with and without abdominal preoperations.
• Analysis of operating time, conversion rate to open surgery, and complications.

Main Results:

• Laparoscopic adrenalectomy via transabdominal approach is feasible in all cases, regardless of abdominal preoperation.
• No conversions to open surgery were required in patients with prior abdominal surgery.
• No significant difference in outcomes was observed between groups.

Conclusions:

• Transabdominal laparoscopic adrenalectomy is a safe and effective approach for benign adrenal tumors, even in patients with a history of abdominal surgery.
• Prior abdominal surgery does not necessitate a change in surgical approach or lead to increased conversion rates.
• The retroperitoneoscopic approach is not necessarily advantageous in cases with intestinal adhesions.