[Laparoscopic adrenalectomy in giant masses]

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Endocrinology

Background:

• Laparoscopic adrenalectomy is the standard for adrenal masses < 6 cm.
• The use of laparoscopy for large adrenal masses (> 6 cm) remains debated.
• This study investigates the feasibility of laparoscopic adrenalectomy for adrenal masses between 7 and 15 cm.

Framework:

• Retrospective case series of six patients undergoing laparoscopic adrenalectomy for large adrenal masses (7-15 cm).
• All patients underwent comprehensive endocrinological evaluation and CT scans.
• The study details the surgical technique, including flank approach, trocar placement, and specimen extraction.

Implementation:

• Six patients (4 male, 2 female) with adrenal masses ranging from 7 to 15 cm underwent laparoscopic adrenalectomy.
• The procedure involved a flank approach, with 4-5 trocars, pneumoperitoneum, and meticulous dissection.
• Specimens were extracted using an endobag, with a mean operative time of 120 minutes and minimal blood loss (50 cc).

Implications:

• Laparoscopic adrenalectomy is a feasible and effective option for large adrenal masses, offering reduced morbidity and shorter hospital stays.
• Careful preoperative diagnosis is essential to identify contraindications, particularly adrenal cortical carcinoma.
• This approach expands the application of minimally invasive surgery in adrenal disease management.