ABSTRACT
The first recorded adrenalectomy involved the en bloc removal of a 9 kg tumor from a 36-year-old woman with hirsutism and virilizing features (most probably a malignant adrenocortical carcinoma [ACC]) by Thornton in 1889. Over the last decade, increasing experience has accumulated with laparoscopic adrenalectomy such that it accounts for greater than 75% of adrenal resections in some centers. Laparoscopic adrenalectomy has largely supplanted the open approach for resection of both benign and malignant lesions. While the exclusion criteria for laparoscopic adrenalectomy are ever diminishing, it is still relatively contraindicated for large malignant neoplasms or malignancies with potential lymph node involvement. Trocar positioning is similar to laparoscopic right adrenalectomy with the most medial port located along the linea alba and the most lateral port located at the mid to posterior axillary line. Laparoscopic adrenalectomy has been shown to be a safe and cost-effective approach to the resection of benign lesions.
