Prospective Randonmized Comparison of Needlescopic Versus Conventional Laparoscopic Adrenalectomy
Prospective Randonmized Comparison of Needlescopic Versus Conventional Laparoscopic Adrenalectomy
The study is a prospective radonmized comparison between needlescopic adrenalectomy and
 conventional laparoscopic adrenalectomy for benign adrenal tumors less than 5 cm. The
 operative success rate, operative time, intraoperative blood loss, intraoperative or
 postoperative complication, postoperative pain, postoperative hospital stay, convalescence,
 and wound cosmesis were compared.
Needlescopic instruments, defined as those with a diameter of no more than 3 mm. They result
 in smaller incisions than conventional 5- to 12-mm instruments, and thus better cosmesis. It
 may further reduce postoperative pain, hospital stay, and recovery time.

 All operations were performed with the lateral transperitoneal approach. A 12-mm port was
 created near the umbilicus for a 30-degree telescope, and another two(for left lesions) or
 three (for right lesions) 2-mm working ports (Tyco Healthcare, Norwalk, Connecticut, USA)
 were created along the ipsilateral subcostal region. Careful dissection was done with the use
 of a 2-mm hook or scissors electrocoagulator. The adrenal vein of the lesion side was
 isolated and controlled with a 2-mm mini-bipolar coagulation apparatus (Tyco Healthcare) for
 a long segment. The vein was then transected closer to the adrenal gland, leaving the
 coagulated stump at the renal vein or vena cava as long as possible, even when a short right
 adrenal vein was encountered. Then the adrenal gland with the tumor was dissected from its
 surrounding tissues after several tiny vessels were transected with the needlescopic
 instruments mentioned above. The specimen was put into a retrieval bag and removed through
 the umbilical port.
Inclusion Criteria:

 -  Clinical diagnosis of Benign Adrenal Tumors

 Exclusion Criteria:

 -  Suspected adrenal malignancy clinically

 -  Bilateral adrenal disease

 -  Pregnant female