TRANSPERITONEAL LAPAROSCOPIC ADRENALECTOMY IN CHILDREN: INITIAL EXPERIENCE

PURPOSE: The use of mini-invasive approach for adrenalectomy is poorly defined in pediatric patients, although laparoscopic adrenalectomy is considered a standard procedure in adults. The aim of our study is to describe the safety and feasibility of minimally invasive adrenalectomy in children based on surgical skills and results. MATERIALS AND METHODS: This is a retrospective study of four pediatric laparoscopic adrenalectomies performed in our centre between 2009 and 2012. All patients underwent transperitoneal lateral laparoscopic adrenalectomy two of which were right adrenalectomies and two were left. RESULTS: Four laparoscopic adrenalectomies were performed. Indications for surgery were neuroblastoma in two patients, secernent adrenocortical tumor in one patient and adrenocortical nodular hyperplasia in the last one. Patients had a mean age of 87 months (range 17-156) at diagnosis and the average lesion size was 3.23 cm (range 0.7-6.4). All laparoscopic adrenalectomies were successful, no conversions to open surgery were required and no post- operative complications or deaths occurred. The average operating time was 105 minutes (range 80-130), blood loss during surgery was minimal and the mean post-operative hospital stay was 3.75 days (range 3-5). None of the patients showed signs of recurring disease at 15-months follow- up. CONCLUSIONS: Laparoscopic adrenalectomy is a safe, feasible and reproducible technique offering numerous advantages including shortening of operating times and post-operative hospital stays, as well as reduction of blood loss and complications. It also provides good visibility and easy access to other organs.