Retroperitoneal laparoendoscopic single-site adrenalectomy: our initial technical experience.

Objective: We performed retroperitoneal laparoendoscopic single-site (LESS) adrenalectomy using a homemade multi-access platform to evaluate the feasibility and safety of this technique and to share our initial experiences.

Patients And Methods: Since March 2011, 40 patients underwent retroperitoneal LESS adrenalectomy. A single incision of 2.5-3 cm was made under the 12th rib on the midaxillary line on the affected side. Next, a homemade multi-access platform was inserted through that incision, and a combination of lengthened curved and conventional rigid instruments was used for handling. The procedure was performed mainly according to the procedure for conventional laparoscopic retroperitoneal adrenalectomy.

Results: For 1 patient with pheochromocytoma, one additional trocar was used because the peritoneum was damaged. Surgery was successfully completed in all other patients without conversion to conventional laparoscopic or open surgery.

Conclusions: Retroperitoneal LESS adrenalectomy is feasible; although initial technical adjustments are inevitable, some useful techniques are effective in simplifying the procedure.