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Laparoscopic Adrenalectomy
The body’s two adrenal glands, although small in size,
have several big jobs. Blood pressure, fluid and salt
regulation, sexual drive, and sugar metabolism are all
affected by the hormones produced by these glands, which
are also the body’s source for naturally occurring steroids
and epinephrine. A gland is located near the top of
each kidney.
There are a variety of conditions that may require
the removal of one or both adrenal glands: Adrenal cancer;
pheochromocytoma—a benign tumor that can result in high
blood pressure; Cushing’s syndrome; Conn’s syndrome;
and more. The body can function normally with only one
adrenal gland; when both are removed, replacement steroids
are the lifetime course of treatment.
Removing the Adrenal Gland
An adrenal gland removed through "open" surgery
requires that a large incision be made either in the
abdomen or the back. To access the gland through the
back, the bottom rib is removed, and there is limited
visibility of the gland. After the surgery, there may
be resultant chronic pain along the incision area.
Adrenalectomy can also be done using laparoscopic
techniques and instruments. Instead of large incisions,
four or five 1/4 inch to 1 inch incisions are made on
the affected side of the body for insertion of the laparoscope—a
thin, telescope-like instrument attached to a camera—and
specially designed surgical instruments. The camera,
with its magnification abilities, provides a detailed
look at the entire gland. The special instruments lift
the organs surrounding the gland out of the way, and
the gland is then removed and placed in a bag that can
be slipped out of one of the small incisions. Laparoscopic
adrenalectomy generally results in less post-operative
pain. An average hospital stay of 2 to 3 days is shorter
than the 5 to 7-day stay anticipated with open surgery.
Recuperation time is usually faster, also.
Laparoscopic adrenalectomy is a relatively new
procedure, having been developed in the mid 1990s, and
not every surgeon performs it. While there are many
benefits to the procedure, there may be times—namely,
when the tumor is large—that the open procedure may
be a more appropriate choice.
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Procedures
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