Abstract：Objective: To investigate the surgical method and operational skills of transperitoneal laparoscopic adrenalectomy (TLA) in the treatment of adrenal adenoma. Methods: From Jan. 2011 to Dec. 2013, in total 312 cases of adrenal adenoma were treated by TLA. Adrenal tumors located at left in 160 and right in 152 cases with an average diameter was (2.2±0.8)cm. The lowest location of adrenal gland was dissected and drawed upward firstly, then accompanied by the moving of "barycenter site", soon quickly cutting technique was used near to the borderline of adrenal gland and adenoma. Results: All of the 312 cases were successfully operated by TLA, no converted to open. The average operating time was (12±3)min, the mean blood loss was (20±6)mL. 1 case suffered diaphragm injury, 1 had a right renal vein crevasse, 1 suffered liver bruise and 1 had a lacerating wound of kidney capsule, no tardive hemorrhoea. 2 cases of incision infection and 2 cases of Addisonian crisis occurred and healed. Postoperative hospital stay was 3 to 7 days with an average of (6±3) d. The definitive diagnosis include 123 cases of primary hyperaldosteronism adenoma, 106 cases of Cushing's adenoma and 83 cases of non-functioning adrenal adenoma. Conclusions: TLA of "barycenter tractive method" is one of the favorable approaches for the treatment of adrenal adenoma, the procedure is with precise surgical step and well-defined anatomic landmarks, so the operation could be completed quickly and followed with reliable curative effects.
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