A laparoscopic procedure is considered the treatment of choice for adrenalectomy. We report the experience of a nonreferring unit for adrenal pathology; we have evaluated its safety and feasibility in a series of 40 patients. From 1994 to 2001, forty consecutive patients underwent laparoscopic adrenalectomy, 37 with transperitoneal and 3 with retroperitoneal approach. The mean operative time was 129 +/- 51.7 minutes (range 60-300): 107 +/- 29 minutes (range 60-100) for the right-sided transperitoneal adrenalectomy and 144 +/- 62 minutes (range 90-300) for the left-sided transperitoneal adrenalectomy. The mean intraoperative blood loss was 90 mL (range 40-200). The procedure laparoscopic was converted to open in one case for the presence of a voluminous angiolipoma arising from the retroperitoneal fat strictly adherent to the adrenal gland. The postoperative morbidity rate was 5.1 per cent. Pain medication was required for a mean period of 1.6 +/- 0.6 days (range 1-3). The patients were able to resume solid food after an average time of 1.8 +/- 0.7 days (range 1-4). Postoperative hospital stay was 3 +/- 1.4 days (range 2-8). We believe that laparoscopic adrenalectomy is safe and effective in removing benign functioning or nonfunctioning adrenal masses and also in a general surgery department.