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A Canadian centre's experience with prone retroperitoneoscopic adrenalectomy
Kathleen Garber1, Khalil Merali2, Adrienne Melck2
1From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Garber); the Department of Surgery, Powell River Hospital, Powell River, BC (Garber); the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (Melck); the Department of Surgery, St. Paul's Hospital, Vancouver, BC (Melck); and the University of British Columbia, Vancouver, BC (Merali) k.garber@alumni.ubc.ca.
Posterior retroperitoneoscopic approach (PRA) for adrenalectomy is faster and leads to shorter hospital stays compared to the transperitoneal laparoscopic approach (TLA). This makes PRA a preferred method for minimally invasive adrenalectomy in selected patients.
Area of Science:
- Endocrine Surgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Minimally invasive adrenalectomy is standard for benign adrenal disease.
- Transperitoneal laparoscopic approach (TLA) is common, but posterior retroperitoneoscopic approach (PRA) offers advantages.
- This study details experience with the PRA.
Purpose of the Study:
- To compare the outcomes of posterior retroperitoneoscopic approach (PRA) versus transperitoneal laparoscopic approach (TLA) for minimally invasive adrenalectomy.
- To evaluate patient and tumor characteristics, operative times, and postoperative outcomes.
- To determine the preferred approach for minimally invasive adrenalectomy at the study center.
Main Methods:
- Retrospective review of patients undergoing minimally invasive adrenalectomy (September 2010 - December 2019).
- Comparison between PRA and TLA groups performed by a single endocrine surgeon.
- Analysis of patient/tumor characteristics, operative times, and postoperative outcomes.
Main Results:
- 58 patients underwent PRA, 41 underwent TLA.
- PRA group had lower ASA scores, smaller adrenal glands, and shorter anesthesia prep time, operative time, and hospital stay (2 days vs. 4 days).
- No significant difference in complication rates between PRA and TLA.
Conclusions:
- Posterior retroperitoneoscopic approach (PRA) offers shorter operative time and length of stay for selected patients.
- PRA has become the preferred approach for minimally invasive adrenalectomy at the center.
- PRA is a safe and efficient alternative to TLA for adrenalectomy.
