Extending the use of laparoscopy to the performance of bilateral laparoscopic adrenalectomy is a reasonable alternative for the treatment of ACTH-dependent Cushing's syndrome after failure of surgery for a pituitary adenoma (Cushing's disease) or when the source of ACTH production cannot be resected or localized.[38]. This evidence concerns the gene POMC and Cushing syndrome due to macronodular adrenal hyperplasia.