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The purpose of this study was to evaluate the safety and efficacy of the modified lateral transperitoneal (MLTP) approach in comparison with the traditional lateral transperitoneal (LTP) and lateral retroperitoneal (LRP) approach. From January 2008 to December 2012, 287 patients underwent laparoscopic adrenalectomy, and the MLTP, LTP and LRP approaches were used in 93, 96 and 98 patients. The patients' demographics and surgical outcomes from the three approaches were reviewed and compared. There were no significant differences in the general demographic or postoperative recovery variables among the three groups. However, the average volume of blood lost was lower for the MLTP group than for the other two groups. Additionally, the average operative time was significantly shorter in the MLTP group than in the LTP group and slightly shorter than in the LRP group, but the differences were not statistically significant. This study shows that the MLTP approach is a safe and effective procedure which is associated with shorter operative time and lower volumes of blood loss.

Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy