Laparoscopic adrenalectomy for primary aldosteronism: report of initial ten cases

Although laparoscopic technique has become popular in the surgical field, the value of laparoscopy in the removal of adrenal gland is unknown. The objective of this study was to examine the feasibility of laparoscopic adrenalectomy.

Between January 17, 1992, and March 16, 1993, 10 patients (four men, six women; mean, 48.2 years of age) with primary aldosteronism underwent laparoscopic adrenalectomy (seven of left adrenal gland and three of right adrenal gland) with almost the same devices as laparoscopic cholecystectomy.

Adrenal tumors were successfully removed with adjacent normal adrenal gland in every patient. The operative time ranged from 165 to 572 minutes (mean, 295 minutes), and the operative bleeding ranged from 50 to 920 ml (mean, 270.5 ml) without requiring blood transfusion. Only one patient required open hemostasis because of uncontrollable bleeding complicated by dislocation of vascular clip in spite of successful laparoscopic removal of adrenal tumor. There was no major complication except for this case.

Laparoscopic adrenalectomy is a relatively safe, alternative operative method for primary aldosteronism, but application of this technique to other types of adrenal lesions remains to be studied.