[Evolution of laparoscopic adrenal surgery in a general surgery department]

To evaluate the reproducibility, safety and short-term results of laparoscopic adrenal surgery during the first few years after its introduction in our department.

A prospective analysis of data of all patients who underwent laparoscopic adrenalectomy in our endocrine surgical unit over a 4-year period. Demographic data, medical history, diagnosis, adrenal and tumour size, technique, conversions, complications and hospital stay were re-viewed. All patients were treated with a laparoscopic transperitoneal lateral approach.

Twenty-four laparoscopic adrenalectomies were performed on 23 consecutive patients (one underwent bilateral adrenalectomy). There were 15 females and 8 males; the mean age was 49.6 years (range, 20-72). There were obesity and vascular hypertension in half of the patients. The indications for surgery were: 8 incidentalomas, 6 aldosterone-producing adenomas, 5 Cushing's adenomas, 3 phaeochromocytoma and 2 metastasis. Right adrenalectomy was performed on 11 patients, left on 11 and one was bilateral. Three cases required open conversion. Respiratory tract infection and hypertensive crisis were the postoperative complications. There was no mortality. The mean operative time was 125 minutes (range, 70-265). The mean size of adrenals excised was 6.5 cm (range, 4-14). The mean size of tumours excised was 4.6 cm (range, 1.5-12). The mean hospital stay was 3.5 days (range, 2-11).

Laparoscopic adrenalectomy is a safe, reproducible and effective procedure with low complication rates, and well tolerated by the patients. The operating time and the length of hospital stay have decreased with the confidence of the technique.