Laparoscopic adrenalectomy: Experience in six cases

Laparoscopic adrenalectomy was performed on six patients (three men and three women, aged 32 to 64 years old) who had three primary aldosteronisms and three nonfunctioning tumors. The tumor size on CT scan was 10 35mm (mean, 20mm), with three of them being left adrenal tumors and three of them being right adrenal tumors. The first trocar was inserted by open laparoscopy, and pneumoperitoneum was performed with CO₂ gas under 8mmHg of pressure. The operative time was 300 to 465 minutes (mean, 383min.), the intraoperative blood loss was 30 to 200ml (mean, 84ml), and the resected tumors weighed 8 to 13g (mean, 11g). Histologically, all of the tumors were cortical adenomas. All of the patients could walk within two days after the operation and the postoperative hospital stay varied between 7 and 32 days (mean, 16 days). Complications were minimal. Compared with 12 former primary aldosteronism patients who received open surgery with the flank approach, the operative time of laparoscopic adrenalectomy was longer, however, the blood loss was less and the hospital stay was shorter. Laparoscopic adrenalectomy is not necessarily any less invasive than the former method of open surgery because of its longer operative time, however, the convalescence time is shorter. Moreover, adrenal tumors are thought to be a good subject for laparoscopic surgery.