Laparoscopic adrenalectomy in urological centres - The experience of the German Laparoscopic Working Group

Francesco Greco*, M. Raschid Hoda, Jens Rassweiler, Dirk Fahlenkamp, Dietmar A. Neisius, Andreas Kutta, Joachim W. Thüroff, Andreas Krause, Walter L. Strohmaier, Alexander Bachmann, Lothar Hertle, Gralf Popken, Serdar Deger, Christian Doehn, Dieter Jocham, Tillmann Loch, Sven Lahme, Volker Janitzky, Christian P. Gilfrich, Theodor KlotzBernd Kopper, Udo Rebmann, Tilman Kälbe, Ulrich Wetterauer, Armin Leitenberger, Jörg Raßler, Felix Kawan, Antonino Inferrera, Sigrid Wagner, Paolo Fornara

*Corresponding author for this work
30 Citations (Scopus)


OBJECTIVE • To evaluate the safety and feasibility of laparoscopic adrenalectomy (LA) performed in several German centres with different laparoscopic experience, as LA has become the gold-standard approach for benign surgical adrenal disorders; however, for solitary metastasis or primary adrenal cancer its precise role is uncertain. PATIENTS AND METHODS • The data of 363 patients who underwent a LA were prospectively collected in 23 centres. • All centres were stratified into three groups according to their experience: group A (<10 LAs/year), group B (10-20 LAs/year) and group C (>20 LAs/year). • In all, 15 centres used a transperitoneal approach, four a retroperitoneal approach and four both approaches. • Demographic data, perioperative and postoperative variables, including operating time, surgical approach, tumour size, estimated blood loss, complications, hospital stay and histological tumour staging, were collected and analysed. RESULTS • The transperitoneal approach was used in 281 cases (77.4%) and the retroperitoneal approach was used in 82 patients (22.6%). • In all, 263 of 363 lesions (72.5%) were benign and 100 (27.5%) were malignant. • The mean (sd) operating time was 127.22 (55.56) min and 130.16 (49.88) min after transperitoneal and retroperitoneal LA, respectively. • The mean complication rates for transperitoneal and retroperitoneal LA were 5% and 10.9%, respectively. CONCLUSION • LAs performed by urologists experienced in laparoscopy is safe for the removal of benign and malignant adrenal masses. LA for malignant adrenal tumours should be performed only in high-volume centres by a surgeon performing at least >10 LAs/year.

Original languageEnglish
JournalBJU International
Issue number10
Pages (from-to)1646-1651
Number of pages6
Publication statusPublished - 01.11.2011


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