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Surgical Innovation
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Surgical Technique of Laparoscopic Adrenalectomy

Jacques Marescaux, MD

European Institute of Telesurgery (EITS) - IRCAD, Clinique Chirurgicale A, Hôpital Civil, Strasbourg, France

Didier Mutter, MD, PhD

European Institute of Telesurgery (EITS) - IRCAD, Clinique Chirurgicale A, Hôpital Civil, Strasbourg, France

Laparoscopic adrenalectomy was first described in 1992. This technique seemed to offer several advantages when compared to conventional surgery but the best laparoscopic strategy is not yet well defined. To achieve safe and complete gland dissection for any pathology and patient, a technique based on a primary vascular control is proposed. This technique, which can be used for right and left adrenalectomy, is described, noting specific risks and dangers of each gland dissection. Adrenalectomy is performed via a transperitoneal route on a patient placed in a lateral position. All vessels are precisely identified, the main adrenal vein being ligated first. The three main arterial pedicles are separately dissected and controlled by clip application before section. Compared to conventional operative techniques, laparoscopic adrenalectomy appears to be safe and offers several advantages in the postoperative course, including low postoperative pain, fast recovery, and short in-hospital stay.

Key Words: Adrenal gland • laparoscopy • surgery • technique.

Surgical Innovation, Vol. 4, No. 4, 223-229 (1997)
DOI: 10.1177/155335069700400406
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