2D <em>versus</em> 3D Laparoscopic Adrenalectomy: A Single-Centre Experience.

OBJECTIVE: To compare operative performance and perioperative outcomes between two-dimensional (2D) and three-dimensional (3D) laparoscopic systems in minimally invasive adrenalectomy. STUDY DESIGN: An observational study. Place and Duration of the Study: Department of Surgical Oncology, Mersin City Training and Research Hospital, Mersin, Turkiye, from January 2023 to November 2025. METHODOLOGY: Patients who underwent laparoscopic adrenalectomy performed by a single surgeon were retrospectively evaluated. The 2D and 3D laparoscopic systems were compared in operative time, estimated blood loss, tumour size, postoperative complications, conversion to open surgery, and length of hospital stay. Continuous variables were analysed using the independent samples t-test or the Mann-Whitney U test according to the data distribution. Categorical variables were compared using the chi-square or Fisher's exact test. A p-value of <0.05 was considered statistically significant. RESULTS: A total of 41 patients were included (3D: n = 22; 2D: n = 19). The 3D group demonstrated significantly shorter operative time [62.5 (60-75) vs. 100 (85-120) minutes; p <0.001], lower intraoperative blood loss [20 (18-20) vs. 200 (100-300) mL; p <0.001], and shorter hospital stay [2 (2-3) vs. 4 (3-7) days; p <0.001]. Tumour size was smaller in the 3D group, although the difference was not statistically significant [40.5 (32-47) vs. 50 (39-70) mm; p = 0.069]. Postoperative complication rates were similar between groups. CONCLUSION: 3D laparoscopic adrenalectomy may improve operative performance and perioperative outcomes compared with conventional 2D laparoscopy. However, the retrospective design and relatively small sample size require cautious interpretation of the findings, and larger prospective studies are needed. KEY WORDS: Laparoscopic adrenalectomy, Three-dimensional laparoscopy, Adrenal tumours, Minimally invasive surgery, Surgical outcomes.