Suprasplenic, transperitoneal approach for laparoscopic adrenalectomy on the left side

Abstract.

Background: There are several minimally invasive means of exposing the adrenal glands. Each of them has its own advantages and disadvantages. A new approach was introduced for laparoscopic adrenalectomy on the left side. Patients and methods: Between June 1997 and January 2000, 23 transperitoneal unilateral laparoscopic adrenalectomies on the left side were performed. In 4 of these cases, only enucleation of a well-circumscribed adenoma was done. In a semilateral position, the gland was approached through the splenophrenic ligament with partial mobilization of the spleen. The left adrenal gland was quickly and safely exposed, thus avoiding the complications of transmesocolic exposure. There was no need for extensive mobilization of the spleen or the pancreas. Results: In 20 cases the laparoscopic operation was successfully performed. In 3 cases conversion was necessary because of bleeding. The estimated blood loss was on average 150 ml. The mean operation time was 84 min, the mean postoperative stay 4.5 days. No other major complications were observed. Conclusion: This new method is a safe and quick technique for left-sided laparoscopic adrenalectomy, and it can be an alternative to the existing ones.