介紹：自1992年以來腹腔鏡腎上腺切除術已逐漸變成移除腎上腺腫瘤的標準術式。我們在此報告經由側面後腹腔施行腹腔鏡腎上腺切除術的經驗，並使用雙極電燒或超音波刀而非血管夾來控制腎上腺血管。材料與方法：自2002年1月至2005年6月，共28位病患於本院接受後腹腔腹腔鏡腎上腺切除術(LRA)。術前電腦斷層發現腫瘤大於5公分之病患則排除於外。結果：有十位病患為男性，18位病患為女性，平均年齡為47.2歲。平均身體質量指數為22.9。腫瘤位於右邊者有14位，左邊者有14位。一位病患(3.6%)轉為開放式手術。平均手術時間為150分鐘，平均出血量小於50毫升。平均腫瘤大小為2.8公分（範圍：1.0~5.5公分），平均住院天數為5.57天（範圍：4~13天）。平均術後禁食時間為24小時，而引流管平均置放時間為3.64天。比較雙極電燒或超音波刀方面，在手術時間及術中出血並無差異性。結論：後腹腔腹腔鏡腎上腺切除術對於良性功能性或無功能性之腎上腺腫瘤為可實行之術式。使用雙極電燒或超音波刀取代血管夾來控制腎上腺血管亦是有效且安全的。

OBJECTIVES: Since 1992, the laparoscopic adrenalectomy has gradually become the standard operation for removing adrenal tumors. We report our experience with laparoscopic adrenalectomies via a lateral retroperitoneal approach and the use of a bipolar coagulator or Harmonic scalpel instead of endoclips to control the adrenal vessels.MATERIALS AND METHODS: From January 2002 to June 2005, 28 patients received a laparoscopic retroperitoneal adrenalectomy (LRA) at Mackay Memorial Hospital. Patients whose with tumor exceeded 5 cm in dimeter on preoperative computed tomography or with a prior lumbar incision were excluded from this series.RESULTS: Ten of the patients were men and 18 were women with a mean age of 47.2 years. The mean body mass index was 22.9 units. The tumor was located on the right side in 14 patients and on the left side in 14 patients. In 1 patient (3.6%), the operation was converted to open surgery. The mean operation time was 150 minutes, and the mean blood loss was＜50 ml. No significant differences were found between use of the bipolar coagulator and Harmonic scalpel. The mean tumor size was 2.8 (range, 1.0-5.5) cm, and the mean hospital stay was 5.57 (range, 4-13) days. The mean postoperative fasting time was 24 hours, and the drains remained in place for an average of 3.64 days.CONCLUSIONS: Laparoscopic retroperitoneal adrenalectomy is a viable operative method for benign functional or non-functional adrenal masses. Using a bipolar coagulator or Harmonic scalpel as a substitute for endoclips to control adrenal vessels under laparoscopic vision is effective and safe.