In this thesis explores various aspects minimally invasive adrenalectomy are described, with a focus on the posterior approach (through the back). Since this approach shows favourable outcomes compared to the transabdominal approach, it is preferred for suitable patients. A structured, step-by-step training program is recommended when learning this technique. A preoperative risk calculator may assist in selecting patients, but still requires external validation. Chronic postsurgical pain occurs frequently after minimally invasive adrenalectomy and has a significant impact on quality of life. Furthermore, injury to the subcostal nerve is common after the posterior approach, but spontaneous recovery rates are high, and it does not lead to increased postoperative pain. Although surgical care for malignant adrenal tumours in children is already centralized in the Netherlands, increased collaboration and centralization of care for hormonally active tumours in specialized Dutch adrenal centers may further enhance perioperative outcomes.
Allon van Uitert (1987) graduated as a medical doctor in 2012 and finished his urology training in 2021. In 2019 he started his PhD on adrenal surgery. Since 2023 he has been working as a pediatric urologist at Amalia Children’s Hospital / Radboud university medical center. Additionally, he has been an associate member of the EAU/ESPU Paediatric Urology Guidelines Panel since 2021.