Retroperitoneal laparoscopic adrenalectomy shows significant advantages over transabdominal for adrenal tumors and pheochromocytomas.

• Operative time is reduced by an average of 8.6 minutes.
• Length of stay decreases by about 0.9 days, with lower estimated blood loss (28.1 mL less).
• For tumors larger than 5 cm, operative time benefits increase to 21.4 minutes, and blood loss reduces by 90.7 mL.

Consider retroperitoneal approach, especially for larger tumors, but apply the transabdominal technique for more complex cases.