Dissertation is dedicated to the topical problem of contemporary clinical medicine - the results of surgical treatment of patients with adrenal diseases due to development, perfection and introduction of methodologies of minimally invasive video endoscopic adrenalectomy and adrenal resection. Part of researchers abandons oneself to the idea, that a determinative at the choice of type of operation is a size of tumour. The aim of investigation is to improve the results of surgical treatment of patients with the adrenal diseases due to research of clinical, laboratory and instrumental features of diagnostics of pathology, development, perfection and introduction of methodologies of minimally invasive laparoscopic adrenalectomy and adrenal resection. Worked out and the improved methodologies of video endoscopic operative interventions at adrenal pathology taking into account hormonal activity and sizes of tumour, age and index of body of patient weight. For the first time on the large amount of clinical material comparison of efficiency of open and video endoscopic (laparoscopic, retroperitoneal) adrenalectomies is conducted. The differentiated algorithm is created to describe the application of laparoscopic and retroperitoneal methodologies of minimally invasive surgical interference on adrenal glands (right- and left-side adrenalectomies). Based on the study of clinical and laboratory and instrumental features of diagnosis, development, improvement and implementation of techniques of minimally invasive laparoscopic adrenalectomy and resection of the adrenal glands, the advantages of the endoscopic method were determined according to all the criteria studied: reduction of blood loss by more than 5 times (on average from 290 to 55 ml), the frequency of early complications from 12,0 % to 1,3 %, late complications from 23,0 % to 0,5 %, perioperative mortality (from 3,0 % to 0,2 %), a significant reduction in the severity of the pain syndrome, reduction of time tion in the hospital, the timing of a return to normal diet, the term recovery activities and performance. The complex of measures that diminish the risk of surgical and hormonal complications at implementation of video endoscopic interferences on adrenal glands is first worked out. Priority data is based on volume of operative intervention on adrenal glands depending on character of pathological process and degree of adrenal disorders. Original approaches to the implementation of minimally invasive interventions in the surgical treatment of adrenal diseases have been developed and implemented, which contribute to reducing economic costs by improving the quality of life of patients, reducing the incidence of complications and disability.
