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Laparoscopic Adrenalectomy

Diagram of laparoscopic incision, showing four small spots across the abdomen Laparoscopic procedure.

Laparoscopic adrenalectomy provides patients with a safe and effective way to remove a diseased or cancerous adrenal gland. There are benign as well as malignant forms of adrenal tumors. Many of the benign adrenal tumors secrete hormones such as cortisol, aldosterone, epinephrine, norepinephrine and can result in high blood pressure, facial flushing, weight gain, headaches, palpitations as well as other symptoms. Adrenal cancer, although rare, can grow to a large size. Most benign and malignant adrenal tumors can be removed laparoscopically.

Laparoscopic adrenalectomy is a minimally invasive technique, which provides patients with less discomfort and equivalent results when compared to the larger incision required with traditional open surgery. When compared to conventional open surgery, laparoscopic adrenalectomy has resulted in significantly less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes identical to that of open surgery.

The Surgery

Diagram of open surgery incision across the abdomen Open procedure.

The Operation

Laparoscopic adrenalectomy is performed under a general anesthetic. The typical length of the operation is 3-4 hours. The surgery is performed through 3 small (1cm) incisions made in the abdomen. A telescope and small instruments are inserted into the abdomen through these keyhole incisions, which allow the surgeon to completely free and dissect the diseased adrenal gland without having to place his hands into the abdomen. The adrenal gland is then placed within a plastic sack and removed intact through an extension of one of the existing incision sites.

Potential Risks and Complications

Although this procedure has proven to be very safe, as in any surgical procedure there are risks and potential complications. The safety and complication rates are similar when compared to the open surgery. Potential risks include:

  • Bleeding: Blood loss during this procedure is typically minor (less than 100 cc) and a blood transfusion is needed in less than 5% of patients. If you are interested in autologous blood transfusion (donating your own blood) prior to your surgery, you must make your surgeon aware. When the packet of information is mailed or given to you regarding your surgery, you will receive an authorization form for you to take to the Red Cross in your area.

  • Infection: All patients are treated with intravenous antibiotics, prior to starting surgery to decrease the chance of infection from occurring after surgery. If you develop any signs or symptoms of infection after the surgery (fever, drainage from your incisions, urinary frequency/discomfort, pain or anything that you may be concerned about) please contact us at once.

  • Tissue / Organ Injury: Although uncommon, possible injury to surrounding tissue and organs including bowel, vascular structures, spleen, liver, pancreas, kidney and gallbladder could require further surgery. Injury could occur to nerves or muscles related to positioning.

  • Hernia: Hernias at incision sites rarely occur since all keyhole incisions are closed carefully at the completion of your surgery.

  • Conversion to Open Surgery: The surgical procedure may require conversion to the standard open operation if difficulty is encountered during the laparoscopic procedure. This could result in a larger standard open incision and possibly a longer recuperation period.

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