The Modified Semi-lateral Transmesocolic Approach for Laparoscopic Left Adrenalectomy

As the most appropriate laparoscopic approach for adrenalectomy is still a matter of debate, we present a modified technique of laparoscopic transmesocolic approach for left adrenalectomy.

All demographics, intraoperative and postoperative data of patients who underwent laparoscopic transmesocolic left adrenalectomy from 2009 to 2015 in Avicenne Hospital were recorded.

Thirty-three consecutive patients underwent laparoscopic transmesocolic left adrenalectomy. We observed no conversion, negligible blood loss, no red cell transfusion or intraoperative complication. Mean operative time reached 96 min (range: 40-200 min). Postoperatively, the median length of hospital stay was 5 days (range: 3-8 days), mortality was nil, and six (19%) patients suffered from complication, including one major complication (Clavien-Dindo III-IV, an abdominal collection treated with radiologic drainage). R0 resection was achieved in all patients.

Laparoscopic left adrenalectomy using semi-lateral transperitoneal transmesocolic approach is feasible and safe with acceptable intraoperative and perioperative outcomes. This technique could be considered as a routine approach and should be compared in further studies.