T R J Gianduzzo and C G Eden

Department of Urology, The North Hampshire Hospital, Basingstoke, Hampshire, U.K.

■ INTRODUCTION AND BACKGROUND

■ PATIENT SELECTION: INDICATIONS AND CONTRAINDICATIONS

Indications Contraindications

■ PREOPERATIVE PREPARATION

■ TECHNIQUE Options

■ LATERAL TRANSPERITONEAL TECHNIQUE Equipment and Theatre Set-Up

Steps

Postoperative Care and Follow-Up

■ TECHNICAL CAVEATS Hemostasis

Open Conversion Organ Injury

■ GENERAL TECHNICAL MODIFICATIONS Procedural Modifications Instrument Modifications

■ ANTERIOR TRANSPERITONEAL TECHNIQUE

■ LATERAL RETROPERITONEAL TECHNIQUE Patient Positioning and Retroperitoneal

Access

Port Placement

Control of the Main Adrenal Vein Specimen Mobilization, Extraction, and Closure

■ POSTERIOR RETROPERITONEAL TECHNIQUE

■ OTHER TECHNIQUES AND MODIFICATIONS Direct Supragastric Left-Sided

Adrenalectomy

Hand-Assisted Laparoscopic Adrenalectomy Needlescopic Laparoscopic Adrenalectomy Thoracoscopic Transdiaphragmatic Adrenalectomy Robotic Surgery

■ CONCLUSION

■ REFERENCES

Laparoscopic adrenalectomy has become the standard surgical approach for most surgically correctable benign disorders of the adrenal gland.

Aldosteronomas may be considered as lesions of choice for surgeons early in the operative learning curve.

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