LAUSR

Minimally invasive adrenalectomy (MIA) has become the favored approach for resection of adrenal tumors that are benign. Some indeterminate adrenal masses can also be resected via minimally invasive approaches as long as the masses can be resected completely without capsular violation. The excellent outcomes of MIA have been demonstrated in the hands of experienced surgeons, with fewer complications and shorter recovery compared to open surgery. Since 1992, when Gagner et al. described the first transabdominal laparoscopic adrenalectomy [1], surgeons have explored a range of minimally invasive approaches for adrenalectomy: accessing the adrenal gland via the abdomen or retroperitoneum, using laparoscopic instruments or robotic systems, and applying hand-assisted or single-incision variations. These different approaches to MIA have advantages and limitations that should be considered when developing an optimal operative plan. Here, we present our approach based on our extensive experience of adrenalectomy over two decades (Table 1).