Impact of Obesity on Outcomes of Laparoscopic Adrenalectomy

Aim: Obesity is a well-known risk factor for surgical complications. Laparoscopic adrenalectomy is now preferred over open surgery for adrenal masses of <6 cm without high malignancy suspicion. This study evaluates the impact of obesity on surgical complication rates in laparoscopic adrenalectomy. Materials and Methods: Patients who underwent laparoscopic transabdominal adrenalectomy between 2013 and 2024 were retrospectively analyzed. They were divided into two groups: obese (BMI ≥30 kg/m 2 ) and nonobese (BMI <30 kg/m 2 ). Demographic data, perioperative, and postoperative outcomes were compared. Results: A total of 110 patients (75 females, 35 males) were included, with 40 in the obese group and 70 in the nonobese group. The mean age was 46.6±12.4 years, and the mean BMI was 28.7±5.5 kg/m 2 . Surgery was performed on the right side in 58 patients (52.7%), left side in 51 (46.4%), and bilaterally in 1 (0.9%). The most common indications were Cushing syndrome (38 patients), pheochromocytoma (31), Conn syndrome (11), and incidentaloma (28). There were no significant differences between groups in terms of operative time, blood loss, tumor size, pathology, and hospital stay. Postoperative complications occurred in 6/40 obese (15.0%) and 3/70 nonobese (4.3%) patients, without a statistically significant difference ( P =0.07). Complications in the obese group included wound infection (4 cases), toxic hepatitis (1), atrial fibrillation (1), and respiratory infection (1). Conclusion: Obesity was associated with a trend toward higher postoperative complication rates, while operative time and length of stay were not significantly different. These findings emphasize the importance of surgical expertise and careful perioperative planning in obese patients.