Abstract

Purpose: With our experience of surgery for adrenal tumors with diameter larger than 10 cm and feasibility and limitations of laparoscopic resection was discussed.

Case presentations: 1) 56 years old, male, pheochromocytoma (right, 10 cm), retroperitoneoscopy, 2) 63 years old, male, myelolipoma (right, 10 cm), retroperitoneoscopy, 3) 68 years old, male, chronic expanding hematoma (left, 18 cm), retroperitoneoscopy with hand-assisted approach 4) 51 years old, male, pheochromocytoma (left, 17 cm), retroperitoneoscopy with lumbar oblique incision. No recurrence was observed for pheochromocytoma.

Conclusion: Early transection of feeding artery caused shrinkage of tumor, less blood loss and facilitated retroperitoneoscoic resection for three cases. On the other hand, increased blood loss was observed after open conversion for two cases, which may be caused by incomplete hemostat during pneumoperitonem. These observations need further discussions for surgical approach against giant adrenal tumors.