Single-port laparoscopic adrenalectomy: initial experience

Background: Recent reports have suggested that single-port laparoscopic surgery is technically feasible. The aim of this study was to describe our initial experience with single-port laparoscopic adrenalectomy (SPLA) for benign adrenal tumors. Methods: Medical records of consecutive patients undergoing SPLA were analyzed. All procedures were performed through a single multichannel port. Demographic and operative data were assessed. A visual analog scale (VAS) was used with a 10-point scale for an objective assessment of incisional pain and incisional cosmesis. Results: Between January 2010 and July 2012, 14 consecutive patients with benign adrenal tumors underwent SPLAs. Of the planned SPLAs, 12 (86%) were completed with a single-port, whereas two required an additional port placement. Mean operating time was 128.1 ± 31.5 min and mean blood loss 10.5 ± 12.1 ml. Mean pain scores using the VAS on postoperative days 1, 3, and 14 were 2.3, 1.0, and 0.3 points, respectively. The rate of analgesic use was also lower within 12 hours after surgery (14%). The patient was highly satisfied with the single small wound procedure, and mean cosmesis scores of postoperative days 3 and 14 were 9.4 and 9.8 points, respectively. The postoperative course was uneventful with no morbidity within one month of follow-up. Conclusions: SPLA is a safe and technically feasible procedure for patients with benign adrenal tumors, and offers a cosmetic benefit, as well. However, further studies are necessary to clearly identify the risks and benefits of this new approach to the adrenalectomy.