Technique and results of the retroperitoneoscopic adrenalectomy via a lumbar approach

Abstract

Introduction: Since 1992, endoscopic techniques have been used increasingly in adrenal-gland surgery. In the present paper, the technique of the retroperitoneoscopic adrenalectomy via a lumbar approach is described. Methods: The patient is placed in a lateral decubitus position. In the first step, a dilatation trocar is introduced in the retroperitoneal space to create an artificial cavity. The dilatation trocar is replaced by a blocking trocar to close off the operating field. After insufflation of CO₂, two additional trocars are introduced in the area of the conventional flank incision. Adrenalectomy is performed via these ports. Once the adrenal gland is completely mobilized, it is inserted into a sterile plastic bag and removed through the 1.5-cm incision. Conclusion: The retroperitoneoscopic approach to the adrenal gland appears to be suitable for benign adrenal-gland tumors up to a size of 6 cm.