{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:01:29Z","timestamp":1790229689922,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Laparoscopic adrenalectomy is the standard surgical approach for most adrenal tumors. Although three-dimensional (3D) transperitoneal laparoscopic adrenalectomy (TLA) is increasingly used, size-stratified perioperative outcomes remain incompletely characterized. We evaluated perioperative outcomes following 3D TLA by comparing patients with adrenal tumors &lt;5 cm and \u22655 cm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted on 57 consecutive patients who underwent 3D TLA at Hospital Episcopal San Lucas between 2018 and 2025. Patients were stratified into a small category (SC) (&lt;5 cm) and a large category (LC) (\u22655 cm). Primary outcomes included operative time, estimated blood loss (EBL), perioperative complications, conversion to open surgery, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-two patients had tumors &lt;5 cm and 35 had tumors \u22655 cm. Median operative time was significantly longer in the large-tumor group (80 versus 60 minutes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). EBL was not significantly different between groups, and median hospital stay was 28.27 hours in the SC group and 29.46 hours in the LC group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .554). More than 90% of patients were discharged within 48 hours. No patients required blood transfusion or conversion to open surgery, and no intraoperative or postoperative complications were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this single-center cohort, 3D TLA was feasible for both small and large adrenal tumors. Tumors \u22655 cm were associated with longer operative time but not with significantly greater EBL or longer hospitalization. More than 90% of patients were discharged within 48 hours, and no conversions, transfusions, or perioperative complications were observed. Because this study lacked a contemporaneous 2D comparator, no conclusions regarding the incremental benefit or superiority of 3D visualization can be drawn.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261491146","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T01:38:24Z","timestamp":1789954704000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Outcomes of 3D Transperitoneal Laparoscopic Adrenalectomy Stratified by Tumor Size"],"prefix":"10.1177","author":[{"given":"Merary","family":"Nazario P\u00e9rez","sequence":"first","affiliation":[{"name":"Urology, Hospital Episcopal San Lucas, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6183-3338","authenticated-orcid":false,"given":"Gustavo","family":"Alay\u00f3n-Rosario","sequence":"additional","affiliation":[{"name":"School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana L.","family":"Col\u00f3n-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Christian-Col\u00f3n","sequence":"additional","affiliation":[{"name":"Surgery, Hospital Episcopal San Lucas, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystell","family":"Ceballos-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Cintron-Cartagena","sequence":"additional","affiliation":[{"name":"Urology, Hospital Episcopal San Lucas, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto","family":"Ru\u00edz-Dey\u00e1","sequence":"additional","affiliation":[{"name":"Urology, Hospital Episcopal San Lucas, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian A.","family":"Ramirez Rivera","sequence":"additional","affiliation":[{"name":"Epidemiology, Hospital Episcopal San Lucas, Ponce, Puerto Rico."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"issue":"8","key":"e_1_3_2_2_1","first-page":"1035","article-title":"Comparison of laparoscopic and open adrenalectomy for adrenal tumors: A meta-analysis","volume":"29","author":"Zhang Y","year":"2019","unstructured":"1.Zhang Y, , Jiang M, , Wang Y, et al. Comparison of laparoscopic and open adrenalectomy for adrenal tumors: A meta-analysis. J Laparoendosc Adv Surg Tech A 2019;29(8):1035\u20131042.","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjad104"},{"issue":"6","key":"e_1_3_2_4_1","first-page":"437","article-title":"Laparoscopic adrenalectomy for large tumours: A systematic review","volume":"97","author":"Constantinides VA","year":"2015","unstructured":"3.Constantinides VA, , Christakis I, , Touska P, et al. Laparoscopic adrenalectomy for large tumours: A systematic review. Ann R Coll Surg Engl 2015;97(6):437\u2013444.","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/ls-22-15"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.4183\/aeb.2020.208"},{"issue":"8","key":"e_1_3_2_7_1","first-page":"e14279","article-title":"The role of three-dimensional laparoscopy in adrenalectomy: A prospective cohort study","volume":"75","author":"Alimoglu O","year":"2021","unstructured":"6.Alimoglu O, , Erol C, , Kaya B, et al. The role of three-dimensional laparoscopy in adrenalectomy: A prospective cohort study. 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