| | Advantages | Disadvantages/contraindications |
| Laparoscopic transabdominal | - Can be combined with other transabdominal procedure
- Easier access for conversion to open procedure
- More suitable in patients with obesity
| - Need to change position for bilateral adrenalectomy
- Need to mobilize abdominal structures
- Not suitable for known or highly suspected malignant tumor (ACC or pheochromocytoma); evidence of invasion into adjacent structures*
|
| Retroperitoneoscopic | - Do not have to mobilize other organs
- Not affected by prior abdominal surgery
- No intraperitoneal insufflation (for patients with potential cardiovascular or respiratory compromise)
- Same position for bilateral adrenalectomy
| - Not suitable for patients with obesity
- Short distance between 12th rib and iliac crest (<4 cm)
- Not suitable for known or highly suspected malignant tumor (ACC or pheochromocytoma); evidence of invasion into adjacent structures*
|
