The aim of this study was to provide an evidence-based systematic review of the use of laparoscopic and robotic adrenalectomy in the treatment of adrenal disease as part of the International Consultation on Urological Diseases and European Association of Urology consultation on Minimally Invasive Surgery in Urology. A systematic literature search (January 2004 to January 2014) was conducted to identify comparative studies assessing the safety and efficacy of minimally invasive adrenal surgery. Subtopics including the role of minimally invasive surgery for pheochromocytoma, adrenocortical carcinoma (ACC) and large adrenal tumours were examined. Additionally, the role of transperitoneal and retroperitoneal approaches, as well as laparoendoscopic single-site (LESS) and robotic adrenalectomy were reviewed. The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analysed and a set of recommendations provided by the committee was produced. Laparoscopic surgery should be considered the first-line therapy for benign adrenal masses requiring surgical resection and for patients with pheochromocytoma. While a laparoscopic approach may be feasible for selected cases of ACC without adjacent organ involvement, an open surgical approach remains the 'gold standard'. Large adrenal tumours without preoperative or intra-operative suspicion of ACC may be safely resected via a laparoscopic approach. Both transperitoneal and retroperitoneal approaches to laparoscopic adrenalectomy are safe. The approach should be chosen based on surgeon training and experience. LESS and robotic adrenalectomy should be considered as alternatives to laparoscopic adrenalectomy but require further study.<br /> (© 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.)
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A systematic literature search (January 2004 to January 2014) was conducted to identify comparative studies assessing the safety and efficacy of minimally invasive adrenal surgery. Subtopics including the role of minimally invasive surgery for pheochromocytoma, adrenocortical carcinoma (ACC) and large adrenal tumours were examined. Additionally, the role of transperitoneal and retroperitoneal approaches, as well as laparoendoscopic single-site (LESS) and robotic adrenalectomy were reviewed. The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analysed and a set of recommendations provided by the committee was produced. Laparoscopic surgery should be considered the first-line therapy for benign adrenal masses requiring surgical resection and for patients with pheochromocytoma. While a laparoscopic approach may be feasible for selected cases of ACC without adjacent organ involvement, an open surgical approach remains the 'gold standard'. Large adrenal tumours without preoperative or intra-operative suspicion of ACC may be safely resected via a laparoscopic approach. Both transperitoneal and retroperitoneal approaches to laparoscopic adrenalectomy are safe. The approach should be chosen based on surgeon training and experience. LESS and robotic adrenalectomy should be considered as alternatives to laparoscopic adrenalectomy but require further study. \u00a9 2016 The Authors BJU International \u00a9 2016 BJU International Published by John Wiley & Sons Ltd.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=27431446","isPdfLink":true,"isSAML":false,"an":"27431446","number_other":"","type_pub":"","issn_electronic":"1464-410X","languages":"English","language":"eng","date_entry":"","date_update":"","titleSource":"BJU international [BJU Int] 2017 Jan; Vol. 119 (1), pp. 13-21. Date of Electronic Publication: 2016 Aug 19.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2017-01-01","description":"The aim of this study was to provide an evidence-based systematic review of the use of laparoscopic and robotic adrenalectomy in the treatment of adrenal disease as part of the International Consultation on Urological Diseases and European Association of Urology consultation on Minimally Invasive Surgery in Urology. A systematic literature search (January 2004 to January 2014) was conducted to identify comparative studies assessing the safety and efficacy of minimally invasive adrenal surgery. Subtopics including the role of minimally invasive surgery for pheochromocytoma, adrenocortical carcinoma (ACC) and large adrenal tumours were examined. Additionally, the role of transperitoneal and retroperitoneal approaches, as well as laparoendoscopic single-site (LESS) and robotic adrenalectomy were reviewed. The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analysed and a set of recommendations provided by the committee was produced. Laparoscopic surgery should be considered the first-line therapy for benign adrenal masses requiring surgical resection and for patients with pheochromocytoma. While a laparoscopic approach may be feasible for selected cases of ACC without adjacent organ involvement, an open surgical approach remains the 'gold standard'. Large adrenal tumours without preoperative or intra-operative suspicion of ACC may be safely resected via a laparoscopic approach. Both transperitoneal and retroperitoneal approaches to laparoscopic adrenalectomy are safe. The approach should be chosen based on surgeon training and experience. LESS and robotic adrenalectomy should be considered as alternatives to laparoscopic adrenalectomy but require further study.<br \/> (© 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=27431446&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Ball MW, Hemal AK, Allaf ME","header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"27431446","RelevancyScore":"817","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"816.878479003906"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=27431446&authtype=shib&custid=ns346513&group=main&profile=eds","physicalDescription":{"Pagination":{"StartPage":"13"}},"additionalInfo":{"Authored_By":"Ball MW, Hemal AK, Allaf ME","Journal_Info":"Publisher: Blackwell Science Country of Publication: England NLM ID: 100886721 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1464-410X (Electronic) Linking ISSN: 14644096 NLM ISO Abbreviation: BJU Int Subsets: MEDLINE","Publication_Type":"Journal Article; Practice Guideline; Review; Systematic Review","Published_Date":"2017-01-01","Source":"BJU international [BJU Int] 2017 Jan; Vol. 119 (1), pp. 13-21. Date of Electronic Publication: 2016 Aug 19.","Languages":"English","Electronic_ISSN":"1464-410X","MeSH_Terms":"Laparoscopy* , Robotic Surgical Procedures*, Adrenal Gland Neoplasms\/*surgery , Adrenalectomy\/*methods, Humans","Subjects":"Humans, Adrenal Gland Neoplasms surgery, Adrenalectomy methods, Laparoscopy, Robotic Surgical Procedures","Title_Abbreviations":"BJU international","Volume":"119"}}
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1464-410X
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["Ball MW, Hemal AK, Allaf ME","Publisher: Blackwell Science Country of Publication: England NLM ID: 100886721 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1464-410X (Electronic) Linking ISSN: 14644096 NLM ISO Abbreviation: BJU Int Subsets: MEDLINE","Journal Article; Practice Guideline; Review; Systematic Review","2017-01-01","BJU international [BJU Int] 2017 Jan; Vol. 119 (1), pp. 13-21. Date of Electronic Publication: 2016 Aug 19.","English","1464-410X","Laparoscopy* , Robotic Surgical Procedures*, Adrenal Gland Neoplasms\/*surgery , Adrenalectomy\/*methods, Humans","Humans, Adrenal Gland Neoplasms surgery, Adrenalectomy methods, Laparoscopy, Robotic Surgical Procedures","BJU international","119"]
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