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2015 ; 4
(5
): 435-41
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Laparoscopic and robotic adrenal surgery: transperitoneal approach
#MMPMID26425457
Okoh AK
; Berber E
Gland Surg
2015[Oct]; 4
(5
): 435-41
PMID26425457
show ga
Recent advances in technology and the need to decrease surgical morbidity have
led a rapid progress in laparoscopic adrenalectomy (LA) over the past decade.
Robotics is attractive to the surgeon owing to the 3-dimensional image quality,
articulating instruments, and stable surgical platform. The safety and efficacy
of robotic adrenalectomy (RA) have been demonstrated by several reports. In
addition, RA has been shown to provide similar outcomes compared to LA.
Development of adrenal surgery has involved the description of several surgical
approaches including the anterior transperitoneal, lateral transperitoneal (LT)
and posterior retroperitoneal (PR). Among these, the most frequently preferred
technique is LT adrenalectomy, primarily due to the surgeon's familiarity of the
operative field, wider working space and visibility. The LT technique is suitable
for the resection of larger, unilateral tumors and in scenarios where conversion
to an open transperitoneal approach is warranted, it offers a lesser burden.
Also, the larger view of the entire abdominal cavity and excellent exposure of
both adrenal glands and surrounding structures provided by the LT technique
render it safe and feasible in pediatric and pregnant individuals.