A new technique for laparoscopic left adrenalectomy.

After the first description of laparoscopic adrenalectomy was published in 1992, this method rapidly attracted widespread interest. Similar to conventional open techniques two main approaches have ben established for the minimally invasive adrenalectomy: the transabdominal and the retroperitoneal. With the transabdominal technique several different routes for exploration of the glands are possible as the patient can be operated on in a lateral, semi-lateral, or even in a supine position for both glands. Determining the best approach for the left side is further complicated because of the many possible techniques for exploration: through the gastrolienal, gastrocolic, or splenophrenic ligaments. The authors have developed a new method for the left laparoscopic adrenalectomy using the splenophrenic approach.