Single-port access adrenalectomy: our initial experience.

Goo, Tiong Thye; Agarwal, Amit; Goel, Rajat; Tan, Charles Tse Kuang; Lomanto, Davide; Cheah, Wei Keat

BACKGROUND After being introduced in 1992, laparoscopic adrenalectomy has been accepted as the gold standard today for benign diseases. The need is now being realized for newer innovations to further reduce the trauma of surgical access. We report our experience and outcome of the first case series of single-port access adrenalectomy by using SILSâ„¢ port. METHODS Between June 2009 and November 2010, 6 patients with adrenal tumors underwent single-port access adrenalectomy via SILS port. The device was placed through a single 3 cm incision. The patients' demographics, adrenal mass characteristics, operative time, conversion rate, intraoperative and postoperative complications, and postoperative pain score were measured. Five patients underwent adrenalectomy by using the retroperitoneal approach and 1 by using the laparoscopic transperitoneal approach. RESULTS Three men and 3 women with mean age 51 years (range, 37-67) underwent single-incision adrenalectomy. The mean tumor size was 3.3 cm (range, 1.5-6). Three of these cases were Conn's syndrome, and the remaining 3 were incidentaloma. No significant complications or conversions to the conventional procedure were recorded. The mean operative time was 121 minutes (range, 70-165). The mean hospital stay was 2.7 days (range, 2-4). No local recurrences or hormonal relapse have been recorded to the present with a median follow-up of 12 months (range, 3-20). CONCLUSIONS In our short experience, single-port access adrenalectomy seems to be safe and feasible in improving the advantages of laparoscopic approach, especially in terms of cosmesis, but further randomized controlled trials are needed to evaluate the benefits of this novel approach.