Preliminary experience with transperitoneal single incision laparoscopic surgery adrenalectomy

Introduction: The aim of contemporary medicine is not only a successful course of the operation, leading to improvement of the patient’s health status, but also its satisfactory cosmetic effect. Single incision laparoscopic surgery (SILS) is a new advance wherein laparoscopy is carried out through a small incision hidden in the umbilicus. It therefore combines these two major objectives allowing for a good clinical result after a practically scarless operation.
Aim: To present the preliminary experience in using the SILS method for treatment of patients with adrenal gland tumours.
Material and methods: In March 2010 we performed 7 SILS adrenalectomies in patients treated in our department. Preoperative examinations confirmed hormonal activity in 6 of them and in 1 patient increase in the size of the tumour (by 12 mm) was the indication for the operation. All procedures were performed using the lateral transperitoneal approach where after creation of a small incision in the umbilicus the SILS port was placed. The operation was then conducted using a technique similar to standard multiport adrenalectomy. In 1 patient it was necessary to place 2 additional trocars in order to properly mobilize the spleen.
Results: We did not observe any difference in the operative time versus multiport laparoscopy. No postoperative complications occurred.
Conclusion: SILS adrenalectomy is a safe procedure but requires a lot of experience in laparoscopic adrenalectomy. If any problem occurs during the procedure it is always possible to place additional trocars and convert the operation to multiport laparoscopy. To date the only evidenced advantage of the new procedure is its better cosmetic result.