Laparoscopic Adrenalectomy: Retroperitoneal Approach

Laparoscopic adrenalectomy has become the gold standard for removal of benign adrenal masses. Despite initial concerns about safety, a long learning curve, and unfamiliarity of anatomy from the posterior approach, the posterior retroperitoneoscopic approach is now the preferred technique at many institutions, and offers several advantages over the transperitoneal approach, including direct access to the adrenal gland, avoiding negotiating scar tissue from previous abdominal operations, and allowing for bilateral surgery without patient repositioning. This review outlines the operative technique, indications and precautions for the posterior retroperitoneoscopic adrenalectomy.