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Naspro et al. Mini-invasive Surg 2021;5:50 https://dx.doi.org/10.20517/2574-1225.2021.77 Page 5 of 6

Single-site laparoscopic adrenalectomy can be comparable to the multi-port approach, as trans-peritoneal is
[16]
comparable to retroperitoneal . The advantages reported for single port surgery are lower blood loss, lower
analgesic time, and improved cosmetic satisfaction against longer operative time. However, our operative
time was lower or comparable to published results, and our perioperative outcomes, postoperative pain,
length of stay, and recovery time were improved. When the diagnosis of adrenal CRCC metastasis was
made, the case was discussed during the weekly multidisciplinary meeting with the oncology team, the
endocrinologist, and radiotherapists, and the final indication was to continue with follow-up and not to
perform immediate systemic treatments. The role of the multidisciplinary approach is pivotal in the tailored
management of these patients.

Minimally invasive surgical approaches and techniques must be tailored case by case according to the
facilities and skills of the surgeon and patient characteristics. In the current report, we show that single-site
retroperitoneal laparoscopic adrenalectomy is a possible procedure for patients who underwent previous
trans-peritoneal abdominal surgery and is an option to consider when determining optimal approaches for
adrenal surgery. However, the retroperitoneoscopic single-site technique should be pursed only when it
does not compromise the overall and oncological safety of the patient and the surgeon has the expertise to
perform the procedure.

DECLARATIONS
Authors’ contributions
Conceptualization, writing - original draft, project administration: Naspro R, La Croce G
Methodology, formal analysis: La Croce G
Data curation, writing - review & editing: Roscigno M, Pellucchi F, Lerner L, Rossini A, Cassibba S
Conceptualization, supervision: Naspro R, Da Pozzo LF

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
A written informed consent for publication was obtained.

Copyright
© The Author(s) 2021.

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