Laparoscopic transabdominal lateral adrenalectomy.

Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey.
Journal of Surgical Oncology (Impact Factor: 2.84). 08/2012; 106(5):611-8. DOI: 10.1002/jso.23250
Source: PubMed

ABSTRACT Laparoscopic adrenalectomy is a mainstay of operative options for adrenal tumors and allows surgeons to perform adrenalectomies with less morbidity, less post-operative pain, and shorter hospital stays. The literature has demonstrated its efficacy to be equal to open adrenalectomy in most cases. With regard to malignant primary and metastatic lesions, controversy still remains, however, consideration of a laparoscopic approach for smaller, well circumscribed and non-invasive lesions is reasonable. During any laparoscopic resection, when there is doubt about the ability to safely remove the lesion with an intact capsule, conversion to an open approach should be considered. The primary goal of a safe and complete oncologic resection cannot be compromised. For most benign lesions, laparoscopic approaches are safe and feasible and conversion to an open approach is necessary only for lesions where size limits the ability of a minimally invasive resection. J. Surg. Oncol. 2012; 106:611-618. © 2012 Wiley Periodicals, Inc.

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    ABSTRACT: Robotic-assisted adrenalectomy is an increasingly used intervention for patients with a variety of surgical adrenal lesions, including adenomas, aldosteronomas, pheochromocytomas, and metastases to the adrenal gland. Compared with traditional laparoscopy, robotic adrenalectomy has comparable perioperative outcomes and is associated with improved hospital length of stay and blood loss, though it does come at a cost premium. Emerging literature also supports a role for robotics in partial adrenalectomy and metastasectomy. Ultimately, well-conducted prospective trials are needed to fully define the role of robotics in the surgical management of adrenal disease.
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