Comparison of Needlescopic vs. Conventional Laparoscopic Adrenalectomy for Tumor Less Than 4 cm

The investigator conduct a randomized clinical trial for the needlescopic and conventional laparoscopic adrenalectomy to assess whether mini laparoscopic adrenalectomy is better than conventional laparoscopic adrenalectomy in terms of pain, complication rate , and wound cosmetics

Inclusion Criteria:Over the age of 20 years old.Primary aldosteronism with unilateral adrenal lesions smaller than 4 cmIndications for laparoscopic surgery.Informed consentExclusion Criteria:Over 80 years oldSuspected adrenal malignancy or pheochromocytomaOther concurrent surgeryPatients who underwent bilateral adrenal tumor resection at the same timeHistory of peritonitis or having undergoing major ipsilateral abdominal surgery.American Society of Anesthesiologists (ASA) Class III or IV (with severe cardiovascular disease, uncontrolled hypertension, diabetes, chronic pulmonary obstructive pulmonary disease, morbid obesity (BMI > 40), dialysis patients, myocardial infarction, stroke, coronary artery disease, liver or coagulation dysfunction, etc.)Opioid addictionPatient have side effects from taking of acetaminophen, celecoxib or opioidsAcute intoxication of alcohol, sleep aids, anesthetics, centrally acting analgesics, opium or psychotropic drugs has occurred.Patients using monoamine oxidase inhibitors (MAOIs) concurrently or within the past 14 days.Patients with chronic pain or respiratory depression (such as chronic obstructive pulmonary disease)Pregnancy