Laparoscopic Transabdominal Right Adrenalectomy

Laparoscopic adrenalectomy via a transabdominal lateral approach is a well-established, safe technique to remove either left or right adrenal. It is generally indicated for all benign functioning lesions of the adrenal gland that measure less than 6 cm. The most common lesion in this category is a cortisol-secreting adenoma, followed by aldosterone-secreting adenoma, nonfunctional lesions between 4 and 6 cm, or benign-appearing lesions that demonstrate interval growth on cross-sectional imaging. This approach is also safe for pheochromocytomas that do not manifest features worrisome for malignancy (metastatic disease, invasion of adjacent tissue). Typically, pheochromocytomas greater than 8 cm have been recommended to be resected with an open approach, but in the absence of worrisome features, this size limit is subject to the technical expertise and experience of the surgeon.