Laparoscopic adrenalectomy: a report of the first experiment in Iran

ABSTRACT

To report the first experiment in laparoscopic adrenalectomy and study its success and immunity in treating different adrenal diseases. From March 1997 to July 2001, 11 patients underwent laparoscopic adrenalectomy through transperitoneal approach. Five of whom were males and 6 were females. Their mean age was 35.5 [range 28 to 52] years. Lesion was located at left in 6 patients and at right in 5. All necessary steps were preoperatively taken including CT scan, MRI, MIBG scan, and endocrine tests such as ACTH, cortisol, mineralocorticoid, 17-hydroxyprogesterone, and VMA. Three [5, 10, and 12 mm] trocars were used in left laparoscopic adrenalectomy and three or four [12, 10, 5, and 5 mm] trocars were applied in right laparoscopic adrenalectomy. All patients have been followed up for three months by physical examination and paraclinical tests. Mean operation time [including anesthesia and surgery] was 205 +/- 65.95 [range 130 to 310] minutes. No significant difference was seen between the operation time in the left and the right adrenalectomy [p=0.5]. Mean hospitalization was 5.54 +/- 3.4 [range 3 to15] days. Mean size of mass was 5.45 +/- 1.7 [range 2 to 8] cm. Blood transfusion was performed in 2 patients and open surgery was conducted for one because of high adhesion. No mortality was reported. During a 3-month follow-up, hormonal tests and blood pressure were normal for all patients, with no medical treatment. This experiment showed that transperitoneal laparoscopic adrenalectomy is an effective and safe approach in the treatment of adrenal masses with the least morbidity