Der Chirurg

, Volume 83, Issue 6, pp 536–545 | Cite as

Minimal-invasive Nebennierenchirurgie

Transperitonealer oder retroperitonealer Zugang?
Leitthema
First Online:

Zusammenfassung

Zur Nebennierenchirurgie stehen heute laparoskopische und retroperitoneoskopische Operationsverfahren in zahlreichen Varianten zur Verfügung. Besondere Bedeutung haben inzwischen der laterale transperitoneal Zugang und der posteriore retroperitoneoskopische Zugang gewonnen. Die Ergebnisse vergleichender Studien zwischen transperitonealen und retroperitonealen Verfahren sind heterogen. Immerhin scheint der retroperitoneale Zugang eine geringere postoperative Schmerzbelastung und schnellere Rekonvaleszenz zu ermöglichen. Alle minimal-invasiven Verfahren gelten als so sicher und zuverlässig, dass die offenen Methoden kaum noch berechtigt sind.

Schlüsselwörter

Adrenalektomie Minimal-invasive Chirurgie Retroperitoneoskopie Single-access-Chirurgie Robotische Chirurgie 

Minimally invasive adrenal gland surgery

Transperitoneal or retroperitoneal approach?

Abstract

Currently adrenal gland surgery can be performed by a variety of laparoscopic and retroperitoneoscopic approaches. Of particular importance are the lateral laparoscopic and posterior retroperitoneoscopic approaches. Comparative studies of transperitoneal and retroperitoneal adrenalectomy demonstrate heterogeneous results. Nevertheless, retroperitoneal techniques may offer less postoperative pain and faster recovery. All these minimally invasive techniques are safe and reliable and have replaced open approaches in most cases.

Keywords

Adrenalectomy Minimally invasive surgery Retroperitoneoscopy Single access surgery Robotic surgery 
This is a preview of subscription content, log in to check access.

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Küster E (1896–1902) Neubildungen der Nebenniere. In: Küster E (Hrsg) Chirurgie der Nieren, der Harnleiter und der Nebennieren. Enke, Stuttgart, S 639–644Google Scholar
  2. 2.
    Higashihara E, Tanaka Y, Horie S et al (1992) A case report of laparoscopic adrenalectomy. Nippon Hinyokika Gakkai Zasshi 83:1130–1133PubMedGoogle Scholar
  3. 3.
    Mercan S, Seven R, Ozarmagan S, Tezelman S (1995) Endoscopic retroperitoneal adrenalectomy. Surgery 118:1071–1075PubMedCrossRefGoogle Scholar
  4. 4.
    Castellucci SA, Curcillo PG, Ginsberg PC et al (2008) Single port access adrenalectomy. J Endurol 22:1573–1576CrossRefGoogle Scholar
  5. 5.
    Walz MK, Alesina PF (2009) Single access retroperitoneoscopic adrenalectomy (SARA) – one step beyond in endocrine surgery. Langenbecks Arch Surg 394:447–450PubMedCrossRefGoogle Scholar
  6. 6.
    Brunaud L, Ayav A, Zarnegar R et al (2008) Prospective evaluation of 100 robotic-assisted unilateral adrenalectomies. Surgery 144:995–1001PubMedCrossRefGoogle Scholar
  7. 7.
    Heintz A, Junginger T (1994) Extraperitoneale endoskopische Adrenalektomie. Chirurg 65:1140–1142PubMedGoogle Scholar
  8. 8.
    Chung SD, Huang CY, Wang SM et al (2011) Laparoendoscopic single-site (LESS) retroperitoneal adrenalectomy using a homemade single-access platform and standard laparoscopic instruments. Surg Endosc 25:1251–1256PubMedCrossRefGoogle Scholar
  9. 9.
    Choi SH, Hwang HK, Kang CM, Lee WJ (2012) Transumbilical single port laparoscopic adrenalectomy: a technical report on right and left adrenalectomy using the glove port. Yonsei Med J 53:442–445PubMedCrossRefGoogle Scholar
  10. 10.
    Berber E, Mitchell J, Milas M, Siperstein A (2010) Robotic posterior retroperitoneal adrenalectomy: operative technique. Arch Surg 145:781–784PubMedCrossRefGoogle Scholar
  11. 11.
    Park JH, Walz MK, Kang SW et al (2011) Robot-assisted posterior retroperitoneoscopic adrenalectomy: single port access. J Korean Surg Soc 81(Suppl 1):21–24CrossRefGoogle Scholar
  12. 12.
    Porpiglia F, Miller BS, Manfredi M et al (2011) A debate on laparoscopic versus open adrenalectomy for adrenocortical carcinoma. Horm Cancer 2:372–377PubMedCrossRefGoogle Scholar
  13. 13.
    Brix D, Allolio B, Fenske W et al (2010) Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol 58:609–615PubMedCrossRefGoogle Scholar
  14. 14.
    Brunt LM, Doherty GM, Norton JA et al (1996) Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. J Am Coll Surg 183:1–10PubMedGoogle Scholar
  15. 15.
    Walz MK, Metz KA, Hellinger A et al (1997) Die Chirurgie primärer unilateraler Nebennierentumoren – Ergebnisse von 154 Patienten. Zentralbl Chir 122:481–486PubMedGoogle Scholar
  16. 16.
    Thompson GB, Grant CS, Van Heerden JA et al (1997) Laparoscopic versus open posterior adrenalectomy: a case-control study of 100 patients. Surgery 122:1132–1136PubMedCrossRefGoogle Scholar
  17. 17.
    Imai T, Kikumori T, Ohiwa M et al (1999) A case-controlled study of laparoscopic compared with open lateral adrenalectomy. Am J Surg 178:50–54PubMedCrossRefGoogle Scholar
  18. 18.
    Walz MK (1998) Minimal-invasive Nebennierenchirurgie. Chirurg 69:613–620PubMedCrossRefGoogle Scholar
  19. 19.
    Giebler RM, Walz MK, Peitgen K, Scherer RU (1996) Hemodynamic changes after retroperitoneal CO2 insufflation for posterior retroperitoneoscopic adrenalectomy. Anesth Analg 82:827–831PubMedGoogle Scholar
  20. 20.
    Baba S, Miyajima A, Uchida A et al (1997) A posterior lumbar approach for retroperitoneoscopic adrenalectomy: assessment of surgical efficacy. Urology 50:19–24PubMedCrossRefGoogle Scholar
  21. 21.
    Suzuki K, Kageyama S, Hirano Y et al (2001) Comparison of 3 surgical approaches to laparoscopic adrenalectomy: a nonrandomized, background matched analysis. J Urol 166:437–443PubMedCrossRefGoogle Scholar
  22. 22.
    Lezoche E, Guerrieri M, Feliciotti F et al (2002) Anterior, lateral, and posterior retroperitoneal approaches in endoscopic adrenalectomy. Surg Endosc 16:96–99PubMedCrossRefGoogle Scholar
  23. 23.
    Terachi T, Yoshida O, Matsuda T et al (2000) Complications of laparoscopic and retroperitoneoscopic adrenalectomies in 370 cases in Japan: a multi-institutional study. Biomed Pharmacother 54(Suppl 1):211–214CrossRefGoogle Scholar
  24. 24.
    Ramacciato G, Nigri GR, Petrucciani N et al (2011) Minimally invasive adrenalectomy: a multicenter comparison of transperitoneal and retroperitoneal approaches. Am Surg 77:409–416PubMedGoogle Scholar
  25. 25.
    Miccoli P, Materazzi G, Brauckhoff M et al (2011) No outcome differences between a laparoscopic and retroperitoneoscopic approach in synchronous bilateral adrenal surgery. World J Surg 35:2698–2702PubMedCrossRefGoogle Scholar
  26. 26.
    Fernandez-Cruz L, Saenz A, Benarroch G et al (1996) Laparoscopic unilateral and bilateral adrenalectomy for Cushing’s syndrome. Transperitoneal and retroperitoneal approaches. Ann Surg 224:727–734PubMedCrossRefGoogle Scholar
  27. 27.
    Rubinstein M, Gill IS, Aron M et al (2005) Prospective, randomized comparison of transperitoneal versus retroperitoneal laparoscopic adrenalectomy. J Urol 174:442–445PubMedCrossRefGoogle Scholar
  28. 28.
    Bonjer HJ, Lange JF, Kazemier G et al (1997) Comparison of three techniques for adrenalectomy. Br J Surg 84:679–682PubMedCrossRefGoogle Scholar
  29. 29.
    Yoneda K, Shiba E, Watanabe T et al (2000) Laparoscopic adrenalectomy: lateral transabdominal approach vs posterior retroperitoneal approach. Biomed Pharmacother 54(Suppl 1):215–219CrossRefGoogle Scholar
  30. 30.
    Takeda M (2000) Laparoscopic adrenalectomy: transperitoneal vs. retroperitoneal approaches. Biomed Pharmacother 54(Suppl 1):207–210CrossRefGoogle Scholar
  31. 31.
    Gockel I, Kneist W, Heintz A et al (2005) Endoscopic adrenalectomy: an analysis of the transperitoneal and retroperitoneal approaches and results of a prospective follow-up study. Surg Endosc 19:569–573PubMedCrossRefGoogle Scholar
  32. 32.
    Gockel I, Vetter G, Heintz A, Junginger T (2005) Endoscopic adrenalectomy for pheochromocytoma: difference between the transperitoneal and retroperitoneal approaches in terms of the operative course. Surg Endosc 19:1086–1092PubMedCrossRefGoogle Scholar
  33. 33.
    Tai CK, Li SK, Hou SM et al (2006) Laparoscopic adrenalectomy: comparison of lateral transperitoneal and lateral retroperitoneal approaches. Surg Laparosc Endosc Percutan Tech 16:141–145PubMedCrossRefGoogle Scholar
  34. 34.
    Duh QY, Siperstein AE, Clark OH et al (1996) Laparoscopic adrenalectomy. Comparison of the lateral and posterior approaches. Arch Surg 131:870–875PubMedCrossRefGoogle Scholar
  35. 35.
    Kiriakopoulos A, Economopoulos KP, Poulios E, Linos D (2011) Impact of posterior retroperitoneoscopic adrenalectomy in a tertiary care center: a paradigm shift. Surg Endosc 25:3584–3589PubMedCrossRefGoogle Scholar
  36. 36.
    Dickson PV, Alex GC, Grubbs EG et al (2011) Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma. Surgery 150:452–458PubMedCrossRefGoogle Scholar
  37. 37.
    Walz MK, Groeben H, Alesina PF (2010) Single-access retroperitoneoscopic adrenalectomy (SARA) versus conventional retroperitoneoscopic adrenalectomy (CORA): a case-control study. World J Surg 34:1386–1390PubMedCrossRefGoogle Scholar
  38. 38.
    Walz MK, Alesina PF, Wenger FA et al (2006) Posterior retroperitoneoscopic adrenalectomy – results of 560 procedures in 520 patients. Surgery 140:943–950PubMedCrossRefGoogle Scholar
  39. 39.
    Zhang X, Fu B, Lang B et al (2007) Technique of anatomical retroperitoneoscopic adrenalectomy with report of 800 cases. J Urol 177:1254–1257PubMedCrossRefGoogle Scholar
  40. 40.
    Gaujoux S, Bonnet S, Leconte M et al (2011) Risk factors for conversion and complications after unilateral laparoscopic adrenalectomy. Br J Surg 98:1392–1399PubMedCrossRefGoogle Scholar
  41. 41.
    Tunca F, Senyurek YG, Terzioglu T et al (2012) Single-incision laparoscopic adrenalectomy. Surg Endosc 26:36–40PubMedCrossRefGoogle Scholar
  42. 42.
    Shi TP, Zhang X, Ma X et al (2011) Laparoendoscopic single-site retroperitoneoscopic adrenalectomy: a matched-pair comparison with the gold standard. Surg Endosc 25:2117–2124PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Klinik für Chirurgie und Zentrum Minimal Invasive ChirurgieKliniken Essen-MitteEssenDeutschland

Personalised recommendations