Transperitoneal or retroperitoneal laparoscopic adrenalectomy: choosing proper technique for certain candidates

Laparoscopic adrenalectomy (LA) is currently the golden standard for the surgical management of small benign adrenal tumors. It is not clear yet if the procedure is appropriate for the management of adrenal malignancies. Transperitoneal or retroperitoneal laparoscopic approaches have been proven feasible and efficient in the surgical resection of the adrenal gland, each of them demonstrating particular advantages and disadvantages. The selection of the approach should be individualized for each patient. Complication rates of LA are similar to open surgery. Operative time is longer, but LA has advantages in terms of postoperative course of the patient. Further experience with LA would elucidate the indications regarding malignant adrenal tumors.