Skip to main content
Log in

One Hundred Laparoscopic Adrenalectomies: A Single Surgeon’s Experience

  • Original Articles
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background: Since the first laparoscopic adrenalectomy was performed in 1992, it has quickly gained acceptance as the standard of care for the treatment of benign adrenal neoplasms. We report a single surgeon’s experience with 100 consecutive laparoscopic adrenalectomies.

Methods: The records of all patients having adrenalectomy at the Johns Hopkins Hospital from 1993 until 2000 were reviewed. We examined the length of stay, time to diet resumption, perioperative morbidity, operative cost, and total cost of 100 consecutive laparoscopic adrenalectomies. These data are compared with those of 20 patients within our institution having open adrenalectomy and with 428 patients statewide having all forms of adrenalectomy during the same time period.

Results: A total of 93 patients had unilateral laparoscopic adrenalectomy and 7 had bilateral procedures. The mean age was 49 years (11 to 70). Indications were aldosteronoma (n = 40), pheochromocytoma (n = 22), glucocorticoid-producing adenoma (n = 14), nonfunctioning adenoma (n = 12) Cushing’s disease (n = 5), and others (n = 7). The median length of stay for this series was 1.0 day. Average length of stay and time to resumption of diet were 1.8 and 1.0 days, respectively. Patients having open procedures during this same time period had an average length of stay of 6.5 days.

Conclusions: Laparoscopic adrenalectomy provides clear advantages over open adrenalectomy. Patients having laparoscopic adrenalectomy have decreased length of stay, shorter time to resumption of diet, and lower total hospital charges when compared with those having open adrenalectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Gagner M, Lacroix A, Prinz RA, et al. Early experience with laparoscopic approach for adrenalectomy. Surgery 1993;114:1120–4.

    PubMed  CAS  Google Scholar 

  2. Lezoche E, Guerrieri M, Paganini AM, et al. Laparoscopic adrenalectomy by the anterior transperitoneal approach: results of 108 operations in unselected cases. Surg Endosc 2000;14:920–5.

    Article  PubMed  CAS  Google Scholar 

  3. Kebebew E, Siperstein AE, Duh QY. Laparoscopic adrenalectomy: the optimal surgical approach. J Laparoendosc Adv Surg Tech A 2001;11:409–13.

    Article  PubMed  CAS  Google Scholar 

  4. Brunt LM, Moley JF, Doherty GM, et al. Outcomes analysis in patients undergoing laparoscopic adrenalectomy for hormonally active adrenal tumors. Surgery 2000;130:629–34; discussion 634–5.

    Article  Google Scholar 

  5. Terachi T, Matsuda T, Terai A, et al. Transperitoneal laparoscopic adrenalectomy: experience in 100 patients. J Endourol 1997;11:361–5.

    PubMed  CAS  Google Scholar 

  6. Borrelli VA, Lucchuse M, et al. Laparoscopic adrenalectomy. Personal experience in 78 patients. G Chir 2001;22:185–9.

    PubMed  Google Scholar 

  7. Salomon L, Soulie M, Mouly P, et al. Experience with retroperitoneal laparoscopic adrenalectomy in 115 procedures. J Urol 2001;166:38–41.

    Article  PubMed  CAS  Google Scholar 

  8. Baba S, Miyajima A, Uchida A, et al. A posterior lumbar approach for retroperitoneoscopic adrenalectomy: assessment of surgical efficacy. Urology 1997;50:19–24.

    Article  PubMed  CAS  Google Scholar 

  9. Suzuki K, Ushiyama T, Ihara H, et al. Complications of laparoscopic adrenalectomy in 75 patients treated by the same surgeon. Eur Urol 1999;36:40–7.

    Article  PubMed  Google Scholar 

  10. Vargas HI, Kavoussi LR, Bartlett DL, et al. Laparoscopic adrenalectomy: a new standard of care. Urology 1997;49:673–-8.

    Article  PubMed  CAS  Google Scholar 

  11. Schell SR, Talamini MA, Udelsman R. Laparoscopic adrenalectomy for nonmalignant disease: improved safety, morbidity, and cost-effectiveness. Surg Endosc 1999;13:30–4.

    Article  PubMed  CAS  Google Scholar 

  12. Udelsman. Laparoscopic adrenalectomy. In: Norton JA, ed. Surgery Practice and Evidence Based. 2001:897–914.

  13. Gagner M, Pomp A, Heniford BT, et al. Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. Ann Surg 1997;226:238–46.

    Article  PubMed  CAS  Google Scholar 

  14. Suzuki K, Kageyama S, Hirano Y, et al. Comparison of 3 surgical approaches to laparoscopic adrenalectomy: a nonrandomized, background matched analysis. J Urol 2001;166:437–43.

    Article  PubMed  CAS  Google Scholar 

  15. Brunt LM, Doherty GM, Norton JA, et al. Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms [see comments]. J Am Coll Surg 1996;183:1–10.

    PubMed  CAS  Google Scholar 

  16. Prinz RA. A comparison of laparoscopic and open adrenalectomies. Arch Surg 1995;130:489–94.

    PubMed  CAS  Google Scholar 

  17. Guazzoni G, Montorsi F, Bocciardi A, et al. Transperitoneal laparoscopic versus open adrenalectomy for benign hyperfunctioning adrenal tumors: a comparative study [see comments]. J Urol 1995;153:1597–600.

    Article  PubMed  CAS  Google Scholar 

  18. Linos DA, Stylopoulos N, Boukis M, et al. Anterior, posterior, or laparoscopic approach for the management of adrenal diseases? Am J Surg 1997;173:120–5.

    Article  PubMed  CAS  Google Scholar 

  19. Winfield HN, Hamilton BD, Bravo EL, Novick AC. Laparoscopic adrenalectomy: the preferred choice? A comparison to open adrenalectomy. J Urol 1998;160:325–9.

    Article  PubMed  CAS  Google Scholar 

  20. Ishikawa T, Sowa M, Nagayama M, et al. Laparoscopic adrenalectomy: comparison with the conventional approach. Surg Laparosc Endosc 1997;7:275–80.

    Article  PubMed  CAS  Google Scholar 

  21. Korman JE, Ho T, Hiatt JR, Phillips EH. Comparison of laparoscopic and open adrenalectomy. Am Surg 1997;63:908–12.

    PubMed  CAS  Google Scholar 

  22. Herrera MF, Grant CS, van Heerden JA, et al. Incidentally discovered adrenal tumors: an institutional perspective. Surgery 1991;110:1014–21.

    PubMed  CAS  Google Scholar 

  23. Korobkin M, Brodeur FJ, Yutzy GG, et al. Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol 1996;166:531–6.

    PubMed  CAS  Google Scholar 

  24. Suzuki K, Ushiyama T, Mugiya S, et al. Hazards of laparoscopic adrenalectomy in patients with adrenal malignancy. J Uro 1997;158:2227.

    Article  CAS  Google Scholar 

  25. Gill IS. The case for laparoscopic adrenalectomy. J Urol 2001;166:429–36.

    Article  PubMed  CAS  Google Scholar 

  26. Terachi T, Matsuda T, Terai A, et al. Transperitoneal laparoscopic adrenalectomy: experience in 100 patients. J Endourol 1997;11:361–5.

    Article  PubMed  CAS  Google Scholar 

  27. Tsuji Y, Yasuhuku M, Haryu T, et al. Laparoscopic adrenalectomy for solitary metachronous adrenal metastasis from lung cancer: report of a case. Surg Today 1999;29:1277–9.

    Article  PubMed  CAS  Google Scholar 

  28. Linos DA, Avlonitis VS, Iliadis K. Laparoscopic resection of solitary adrenal metastasis from lung carcinoma: a case report. J Soc Laparoendosc Surg 1998;2:291–3.

    CAS  Google Scholar 

  29. Heniford BT, Arca MJ, Walsh RM, Gill IS. Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 1999;16:293–306.

    Article  PubMed  CAS  Google Scholar 

  30. Elashry OM, Clayman RV, Soble JJ, McDougall EM. Laparoscopic adrenalectomy for solitary metachronous contralateral adrenal metastasis from renal cell carcinoma. J Urol 1997;157:1217–22.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert Udelsman MD, MBA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zeh, H.J., Udelsman, R. One Hundred Laparoscopic Adrenalectomies: A Single Surgeon’s Experience. Ann Surg Oncol 10, 1012–1017 (2003). https://doi.org/10.1245/ASO.2003.06.001

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1245/ASO.2003.06.001

Key Words

Navigation