[Surgical therapy for adrenal tumours]

Four endoscopic and four open accesses are available for the surgery of adrenal tumours. The decision to use one of the available techniques depends on tumour size, body mass index, previous abdominal surgery and the experience of the surgeon. Currently, the lateral laparoscopic and the dorsal retroperitoneoscopic approaches are most frequently used. Conventional surgery should be used if malignancy is suspected, especially for tumours larger than 6 cm. In individual cases, even tumours up to 10 cm can be operated laparoscopically if there is no suspicion of invasive growth or lymphatic metastases. Each surgeon should choose the most familiar access. The retroperitoneoscopic and laparoscopic accesses for benign adrenal tumours up to 6 cm are considered to be equivalent. The surgeon should also be able to approach adrenal tumours conventionally.