Laparoscopic adrenalectomy by general surgeons familiar with laparoscopic surgical skills: Experiences of a single center

Introduction: Laparoscopic adrenalectomy (LA) is still considered an advanced procedure requiring a high level of skills with potentially lethal pitfalls. We report our clinical outcomes of 50 cases of LA, and discuss whether a general surgeon is suitable to perform LA, and the effect of mentor-initiated training on improving outcomes. Methods: Patients' age and sex, size of tumor, preoperative diagnosis, procedure details, intra- and postoperative complications, operation time, final histological diagnosis, and length of stay of 50 consecutive cases of LA were collected through a review of hospital charts. These cases were divided into two equal consecutive groups. The first 25 cases were named Group A, and the latter 25 cases were named Group B, and two groups were compared. Results: Median operation time in Group B (110 min) was significantly shorter than that in Group A (125 min) (P = 0.021). Mean postoperative hospital stay in Group B (7.0 +/- 2.8 days) was significantly shorter than that in Group A (10.9 +/- 8.8 days) (P = 0.019). Only one case (Group B) of 50 LA (2%) required a conversion to open adrenalectomy because of failure to control bleeding during dissection. Conclusion: Under mentor-initiated training, general surgeons with experience of more than 50 cases of laparoscopic cholecystectomies can attain favorable clinical outcomes in LA.