http://repub.eur.nl/res/aut/46964/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/31259/ 2003-02-21T00:00:00Z The term ‘endoscopy’ is derived from the Greek words endon (= in, inside) and skopein (= to look at or survey) and describes a procedure of investigation of an existing cavity of the body, a hollow organ, or a (surgically) created space. T Laparoscopy is derived from the Greek lapara (= the soft part between the ribs and hip, flank, loin) and refers to the endoscopic inspection of the peritoneal cavity. Endoscopic or laparoscopic visualisation is possible through a rigid tube containing lenses, which casts light on an object and transmitsan image of the object: the scope. The scope is àttached to a camera, which digitalizes the recorded images. These images are projected on a television screen. It should be noted that some organs, for example the adrenal glands are situated in the retroperitoneal space and can be approached both through the peritoneal space (laparoscopically) and from posterior directly through the retroperitoneal space (endoscopically). ‘Laparoscopically assisted’ describes an operative procedure that is performed partly by laparoscopy, followed by a (small) incision to complete the procedure or to extract (a part of) an organ. http://repub.eur.nl/res/pub/31848/ 2000-12-13T00:00:00Z Objective: To evaluate the effectiveness of endoscopic retroperitoneal adrenalectomy (ERA). Summary Background Data: Minimally invasive adrenalectomy has become the procedure of choice for benign adrenal pathology. Although the adrenal glands are located in the retroperitoneum, most surgeons prefer the transperitoneal laparoscopic approach to adrenal tumors. Methods: Clinical characteristics and outcomes of 111 ERAs from January 1994 to December 1999 were evaluated. Results: Ninety-five patients underwent 111 ERAs (79 unilateral, 16 bilateral). Indications were Cushing syndrome (n = 22), Cushing disease (n = 8), ectopic adrenocorticotropic hormone syndrome (n = 6), Conn's adenoma (n = 25), pheochromocytoma (n = 19), incidentaloma (n = 11), and other (n = 4). Tumor size varied from 0.1 to 8 cm. Median age was 50 years. Unilateral ERA required 114 minutes, with median blood loss of 65 mL. Bilateral ERA lasted 214 minutes, with median blood loss of 121 mL. The conversion rate to open surgery was 4.5%. The complication rate was 11%. Median postoperative hospital stay was 2 days for unilateral ERA and 5 days for bilateral ERA. The death rate was 0.9%. At a median follow-up of 14 months, the recurrence rate of disease was 0.9%. Conclusion: For benign adrenal tumors less than 6 cm, ERA is recommended.