[Endoscopic adrenalectomy by retroperitoneal approach for primary aldosteronism]

Endoscopic adrenalectomy by a retroperitoneal approach through the skin incision less than 5 cm has been performed in 6 patients (3 males and 3 females; 4 right and 2 left side) with primary aldosteronism from December 1992 to June 1993. The treatment was successful in all the cases. As for complications, pneumothorax occurred in one case. The required operation time was from 120 to 330 min (mean: 196 min) and the blood loss was from 20 to 279 ml (mean: 94 ml), which were similar to those in open adrenalectomy. The retroperitoneal approach was thought to be more advantageous than widely adopted laparoscopic adrenalectomy in the following points: (1) No complications such as pulmonary embolism or pneumomediastinum. (2) No injuries to the intraabdominal organs. (3) Two operators using one video system is sufficient.