Adrenalectomy

Abstract

The aim of this chapter is to provide, in a step wise manner, the basic principles required to perform a safe laparoscopic adrenalectomy in children. The main indications, contraindications, preoperative considerations, technical tips and special requirements are reviewed. Precise positioning of the patient is extremely important to achieve proper visualization of the adrenal gland. Special instruments such us a 30° telescope, bipolar vessel scaler or ultrasonic scalpel are particularly helpful. The benefits of laparoscopy over laparotomy are especially evident and include peritoneal exploration if indicated, postoperative reduction of analgesia requirement, short recovery time and cosmesis. Laparoscopic adrenalectomy is becoming the procedure of choice for benign lesions in children. The role for malignant tumors is still controversial. © 2009 Springer-Verlag Berlin Heidelberg.