Topic Paper

World Journal of Urology

, Volume 30, Issue 5, pp 597-604

First online:

Laparoendoscopic single site (LESS) adrenalectomy: Technique and outcomes

  • Abhay RaneAffiliated withDepartment of Urology, East Surrey Hospital Email author 
  • , Luca CindoloAffiliated withDepartment of Urology, “S.Pio da Pietralcina” Hospital
  • , Luigi SchipsAffiliated withDepartment of Urology, “S.Pio da Pietralcina” Hospital
  • , Marco De SioAffiliated withUrology Clinic, Second University of Naples
  • , Riccardo AutorinoAffiliated withUrology Clinic, Second University of NaplesGlickman Urological and Kidney Institute

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Abstract

Purpose

To describe the surgical technique, to analyze outcomes and to provide an overview of the current status of laparoendoscopic single site (LESS) adrenalectomy.

Methods

A comprehensive PubMed search was performed for all relevant urological literature regarding LESS and adrenal surgery. In addition, experience gained at the authors’ own institutions was considered. Clinical descriptive and comparative reports on LESS adrenal surgery procedures were analysed.

Results

LESS adrenal surgery has been effectively performed for a number of indications. A wide variety of approaches (transperitoneal versus retroperitoneal, multichannel trocar versus multiple ports, trans- or extraumbilical) have been described. LESS adrenalectomy seems to be safe, taking more time than the standard laparoscopic counterpart but appears to offer the patient less postoperative discomfort. Technical difficulties of the procedure include the requirement of more time for adjustment of articulating instruments, longer ‘one-handed’ manipulation time, and a high peroperative tissue re-grasping rate.

Conclusions

The feasibility and safety of LESS adrenalectomy has been demonstrated. Only long-term follow-up outcomes will prove its benefits over conventional laparoscopy and define the role and the oncological safety of LESS adrenal surgery.

Keywords

Adrenalectomy Laparoendoscopic single-site surgery LESS Single-port surgery