Retroperitoneoscopic adrenalectomy: tips and tricks.

Posterior retroperitoneoscopic adrenalectomy has recently increased in popularity and currently adopted in about 20% of referral centers. It may provide more direct access to the adrenals, thus avoiding post-operative adhesions and the need for patient repositioning in bilateral adrenalectomy. Although it has been suggested to be feasible for large tumors, large tumor size is indicated as the main limitation of PRA, mainly because of the small space available for dissection.