Objects: To describe the surgical technique, to analyze preliminary results , to provide the indications and an overview of the current status of laparoendoscopic single site (LESS) adrenalectomy. Methods and patients: from August 2010 to October, 2011, there was 50 patients (19 men and 31 women) underwent SILS adrenalectomy. The diagnosis consist: 31 corticoadrenals, 14 pheochromocytoma, 3 adrenal cyst and 2 other adrenal tumor. A comprehensive documents was performed for all relevant LESS and adrenal surgery. In addition, experience gained at the authors' own institutions was considered. Clinical descriptive and comparative reports on LESS adrenal surgery procedures were analysed. Results: The operation time was 87 mn (50-150) and blood lost was approximately 76ml. There was no intra- and postoperative complication and the mean post-op hospital stay was 3.2days LESS adrenal surgery has been effectively performed for a number of indications. A wide variety of approaches (transperitoneal versus retroperitoneal, multichannel trocar versus multiple ports, trans- or extraumbilical) have been described. LESS adrenalectomy seems to be safe, taking more time than the standard laparoscopic counterpart but appears to offer the patient less postoperative discomfort. Technical difficulties of the procedure include the requirement of more time for adjustment of articulating instruments, longer 'one-handed' manipulation time, and a high peroperative tissue re-grasping rate. Conclusions:The feasibility and safety of LESS adrenalectomy has been demonstrated. Only long-term follow-up outcomes will prove its benefits and safety of LESS adrenal surgery.
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