[Endoscopic therapy of incidentaloma]

Since 1992 endoscopic surgical techniques have gained importance in adrenal gland surgery. In this review the actual laparoscopic and retroperitoneoscopic techniques and results-taking the own case material into consideration-are represented. The laparoscopic, transperitoneal adrenalectomy shows a low rate of complications (12%). Disadvantages of the transperitoncal approach are the risk of an intraabdominal injury and the problems caused by adhesions after abdominal operations. The retroperitoneoscopic access to the adrenal gland avoids disadvantages of the transperitoneal approach. Concerning the rising frequency of accidentally diagnosed tumors of the adrenal gland the retroperitoneoscopic approach represents a technique which allows a removal of these tumors up to a size 6 centimeters with low morbidity. In case of large tumors of the adrenal gland (size > 6 centimeters) suspected for malignancy we see the indication for the transperitoneal approach.