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Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2022; 10(35): 12812-12821
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12812
Minimally invasive techniques in benign and malignant adrenal tumors
Ahmet Bulent Dogrul, Omer Cennet, Anıl Hilmi Dincer
Ahmet Bulent Dogrul, Omer Cennet, Anıl Hilmi Dincer, Department of General Surgery, Hacettepe University Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey
Author contributions: Dogrul AD conceived the idea for the article; Cennet O and Dincer AH wrote the initial paper; Dogrul AB critically revised the paper; All authors performed the literature search and data analysis, and read and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflict of interests to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmet Bulent Dogrul, Doctor, Associate Professor, Department of General Surgery, Hacettepe University Faculty of Medicine, Hacettepe University, Hacettepe Hacettepe Üniversitesi Tıp Fakültesi Genel Cerrahi AD, Sıhhiye, Altındağ, Ankara 06100, Turkey. adogrul@hacettepe.edu.tr
Received: August 23, 2022
Peer-review started: August 23, 2022
First decision: October 24, 2022
Revised: November 4, 2022
Accepted: November 28, 2022
Article in press: November 28, 2022
Published online: December 16, 2022
Processing time: 112 Days and 20.2 Hours
Abstract

Minimally invasive adrenalectomy has become the main treatment modality for most adrenal lesions. Both laparoscopic transabdominal and retroperitoneoscopic approaches are safe and feasible options, each with respective advantages, including better surgical outcomes, fewer complications, and faster recovery over open adrenalectomy. While open surgery remains a valid modality in treatment of adrenocortical cancer in the presence of some findings such as invasion, robotic platforms, and minimally invasive surgery have gained popularity as technology continues to evolve. Organ preservation during adrenalectomy is feasible in some conditions to prevent adrenal insufficiency. Ablative technologies are increasingly utilized in benign and malignant tumors, including the adrenal gland, with various outcomes. A multidisciplinary team, an experienced surgeon, and a high-volume center are recommended for any surgical approaches and management of adrenal lesions. This review article evaluated recent findings and current evidence on minimally invasive adrenalectomy.

Keywords: Adrenalectomy; Laparoscopy; Retroperitoneoscopic; Minimally invasive surgery; Robotic

Core Tip: Minimally invasive adrenalectomy is the standard treatment for most adrenal lesions. Options to approach the adrenal gland include a transabdominal or retroperitoneoscopic route via laparoscopy or robotic platform. While each presents their own advantages, all are safe and produce excellent outcomes. Although open surgery for adrenocortical carcinoma remains suitable in some situations, partial adrenalectomy may be appropriate in certain cases to prevent adrenal insufficiency.