Retroperitoneal laparoscopic adrenalectomy.

Laparoscopic adrenalectomy is considered to be the standard of care for the surgical excision of the adrenal gland. Since the initial report of laparoscopic adrenalectomy in 1992, it has evolved into a feasible and reproducible minimally invasive procedure for benign adrenal tumors. Transperitoneal and retroperitoneal approaches are the two principal laparoscopic routes to the adrenal gland. Both have proven to be safe and effective when compared with open adrenalectomy, offering the benefits of decreased blood loss, less postoperative pain, shorter hospital stay, rapid convalescence, and improved cosmetic effect. Although the transperitoneal approach is used more widely, the retroperitoneal approach offers distinct advantages that make it a valuable alternative route to the adrenal gland. This article describes retroperitoneal laparoscopic adrenalectomy including indications, operative technique, and a review of the literature.