[Minimally invasive adrenalectomy--comparison of surgical approaches]

Nowadays, minimal invasive operating technique are an essential part of adrenal gland surgery. Meanwhile four different methods are being used: laparoscopically in the supine or lateral position or retroperitoneoscopically as a prone or lateral method. Until now, it is not evident whether laparoscopy or retroperitoneoscopy should be preferred. Laparoscopy offers a familiar anatomical exposure but requires 4-6 trocars. For the retroperitoneoscopic methods only three trocars are needed, whereas orientation in the operating field is more difficult. All endoscopic procedures to the adrenal gland demand high surgical skills. They require expended experience in minimal invasive surgery as well as special knowledge in endocrine surgery.