Background: Laparoscopic adrenalectomy, which was first introduced in 1992, is now regarded as the gold standard for treating various forms of adrenal masses. The authors reported their learning curve and the development of surgical techniques, as well as certain drawbacks associated with surgical outcomes.

Materials and Methods: Between March 2000 and March 2019, the data of all patients that underwent laparoscopic adrenalectomy were compiled and examined. The primary outcome covered all the operative parameter, which include operative time and the learning curve, diagnosis with size, conversion rate, and blood loss. Pre-operative, intra-operative, and post-operative data, including all complications, were secondary outcomes.

Results: Five hundred thirteen surgical procedures in a single center were studied during the 19-year period. In 421 cases, hormone-producing tumors were discovered and included Conn’s syndrome in 275 cases, Cushing’s syndrome in 75 cases, and pheochromocytoma in 71 cases. After the first 50 cases, the mean operative time was significantly lowered. There was also a moderate link between the tumor size and the operational time (Pearson correlation, r=0.315, p<0.05). There were 22 (4.3%) cases of intraoperative complications and 29 (5.7%) cases of postoperative complications. Histopathological reports are available, including adrenocortical carcinoma with the mean tumor size of 3.2cm with a range of 2.5 to 12 cm.

Conclusion: Laparoscopic adrenalectomy has proven to be a safe and successful treatment for most adrenal-related diseases with various sizes. The learning curve should be regarded as a part of training. This method can replace open surgery in a high-volume center, particularly in certain malignant patients.

Keywords: Adrenalectomy; Laparoscopy; Surgical outcomes

DOI: 10.35755/jmedassocthai.2022.01.13236

Received 25 October 2021 | Revised 27 December 2021 | Accepted 28 December 2021