Retroperitoneal laparoscopic liposuction for large adrenal myelolipomas: a report of nine cases

Removing relatively large adrenal myelolipomas using retroperitoneal laparoscopy is difficult and carries risk of intraoperative injury to adjacent organs and vessels. We aimed to introduce a new method of retroperitoneal laparoscopic liposuction with suction units for resection of large adrenal myelolipomas.

From June 2005 to October 2011, 8 patients (nine lesions, including bilateral lesions in 1 patient) with adrenal myelolipoma more than 8 cm in maximum diameter underwent retroperitoneal laparoscopic liposuction with suction units. Patients included 3 males and 5 females with a mean age of 47 years (range, 35-62 years). Tumor resection was performed after deflation and shrinkage of tumor. The mean maximum diameter was 10.5 cm, ranging from 8 to 14 cm. Five tumors were located on the right side, two were on the left side, and one was bilateral. Adrenal computed tomography was done in each patient preoperatively. Round or oval masses were found in dense fat in the adrenal area, and all cases were diagnosed as adrenal myelolipoma. Five patients had backache or abdominal discomfort; three patients had no symptoms.

The mean operation time was 75 minutes, and the mean intraoperative blood loss was 30 mL. The mean postoperative length of stay was 3 days. No significant intraoperative or postoperative complications occurred. The follow-up length ranged from 8 to 77 months. No tumor recurrence was observed.

Retroperitoneal laparoscopic liposuction with suction units is safe and effective for resection of relatively large adrenal myelolipomas. Deflation and shrinkage of the tumor make the operation safer and easier without affecting its pathological diagnosis.