Laparoscopic or open adrenalectomy?

Laparoscopic adrenalectomy is now preferred over open adrenalectomy for removal of most of adrenal tumors. The keys to a successful outcome are careful preoperative assessment of the patient with a comprehensive biochemical evaluation and precise radiographic imaging, a thorough knowledge of adrenal anatomy, and a meticulous and gentle extracapsular dissection technique. Care should be taken in approaching patients with large or potentially malignant adrenal lesions. These tumors should probably be removed in an open fashion unless the surgeon is highly experienced with laparoscopic adrenalectomy.