Laparoscopic adrenalectomy has become the standard of care for a variety of benign adrenal pathologies. A total of 111 consecutive adrenalectomies were performed using a lateral transperitoneal or posterior retroperitoneal approach, each with its own inherent benefits and shortcomings. The authors compared the effectiveness and safety of posterior retroperitoneal adrenalectomy (PRA) with that of lateral transperitoneal adrenalectomy (LTA).

Medical records of 111 patients diagnosed with adrenal tumor who underwent laparoscopic adrenalectomy from January 2000 through April 2012 at Chungnam National Hospital were reviewed retrospectively. Study variables included operative time, length of hospital stay, number of days of pain control, diet beginning and advance, and complications.

PRA was shorter in most variables, including operative time, hospital stay, first diet beginning, and full diet advance time compared with that of LTA. In pheochromocytoma less than or equal to 7 cm in size, operation time for LTA was longer than that of PRA. One PRA-specific complication was pseudo-hernia of the ipsilateral abdominal wall, which was resolved spontaneously within 1~2 months.

Laparoscopic adrenalectomy is a safe and effective approach to benign adrenal pathology, and PRA should be considered in patients with tumors less than or equal to 7 cm.