Category: Laparoscopic/ Robotic: Other

MP17-7 - Transperitoneal Laparoscopic Partial Adrenalectomy in Non-Hereditary Functional Adrenal Adenomas: Experience With 8 Patients

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective : Laparoscopic adrenalectomy is the standard treatment for patients with adrenal masses, but after surgery few patients needs to use steroid because of adrenal failure. Partial adrenalectomy is typically performed for the hereditary bilateral tumors particularly younger patients. This procedure proposes postoperative steroid-free course. In this study, we aimed to present our experience with transperitoneal laparoscopic partial adrenalectomy in 8 patients with hormonal active single non-hereditary adrenal masses. 


Methods : From March 2016 to January 2018, we performed 8 transperitoneal laparoscopic partial adrenalectomies. The key points reside in adenoma identification, preservation of the remaining glandular parenchyma and its blood supply with dissection in the space between the adenoma and the normal parenchyma. Perioperative, functional and oncological outcomes were recorded. 


Results : Of the 8 adrenalectomies, 6 were left and 2 were right adrenal masses. All the masses were smaller than 8 cm and lateral location on the adrenal gland (mean 43.25 cm, 23 to 78). All eight patients were symptomatic at presentation; 4 patients had Cushing syndrome, 2 patients had pheochromocytomas and 2 patients had aldesteronomas. The mean age of the patients was 40.5 (23-51) years and median follow up was 12 (3-24) months. No minor or major postoperative complications occurred. The average surgical time was 70 (40-115) minutes. In histopathological examination, 2 of them were pheochromocytomas and the others were adrenal hyperplasia. After surgery, all patients had resolution of their symptoms and no patient required steroid replacement postoperatively. On postoperative imaging no residual and recurrent mass was detected. 


Conclusions : Transperitoneal laparoscopic partial adrenalectomy is technically feasible and provides good perioperative and postoperative clinical outcomes. Also, the procedure can obviate the need for steroid replacement in the patients.

Altug Tuncel

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Dr. Altug Tuncel received a medical degree from the Gazi University, Ankara, Turkey in 1996 and completed his medical proficiency training at the same university in Urology Department on March 2002. Later he started to work as a chief assistant at the Third Urology Clinic at Ankara Numune Research and Training Hospital of Ministry of Health on July 2002. Then, he got the Scientific and Technological Research Council of Turkey (TUBITAK)’s Postdoctoral Research Scholarship and worked as a research fellow for 9 months at University of Texas (USA), Faculty of Medicine, Southwestern Medical Centre, Department of Urology, Minimally Invasive Surgical Division under the guidance of Prof.Dr.Jeffrey A.Cadeddu and took part in some research projects on endourology and urooncology. At Minimally Invasive Surgical Training Centre of the same Department, he was trained in urologic laparoscopic surgery through practical work at wet laboratory with animal models and at dry laboratory with Virtual Reality Simulator (Lap Mentor®). He also attented laparoscopic operations done by Prof.Dr.Cadeddu as observer. After turning back to Turkey, he has started doing urologic laparoscopic surgeries at the clinic where he is currently working. He got the title of associate professor on December 2008. He was promoted to post of Professor at the University of Health Sciences Faculty of Medicine, Department of Urology, Turkey. Dr.Tuncel who has certificate of Turkish Urology Proficiency Council and Certification of Fellows of the European Board of Urology (FEBU). In his urology practices focuses more on endourology and urooncology.

Melih Balci

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Can Aykanat


Ankara, Ankara, Turkey

Ozer Guzel

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Yilmaz Aslan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Ozgur Akdemir

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey