Laparoscopic Adrenalectomy

WHEN IS ADRENAL SURGERY NEEDED?

An adrenalectomy (the surgical removal of the adrenal gland) may be required in cases of hormone overproduction or if there is a concern that a mass of the adrenal gland may be a cancer. The three scenarios where hormone excess requires adrenalectomy are Cushing's Syndrome, Conn's Syndrome and pheochromocytomas.

Adrenal tumours that are non functioning can be encountered during other radiological tests on the abdomen. Adrenalectomy may be recommended because the risk of cancer increases as the size of the gland increases or because there are other concerning features on scanning of the mass.

HOW IS ADRENAL SURGERY USUALLY PERFORMED?

Adrenalectomy may be performed as an open procedure or a laparoscopic (key hole) procedure. Open operations may be performed through the back (sometimes requiring partial removal of a rib), the flank, or the front of the abdomen. Laparoscopic procedures less invasive and are usually performed from the front and side of the abdomen.

The method of adrenalectomy depends on the disease being treated, tumor size, and general patient health but overall with the exception of definite cancer the laparoscopic approach is preferred.

LAPAROSCOPIC ADRENALECTOMY

The first pioneering laparoscopic adrenalectomy was performed in the 1992 and following refinement of the technique this has become the method of choice for removing benign adrenal tumours. This minimally invasive adrenal surgery has numerous advantages over the older open technique including smaller incisions and therefore less stress for the patient, less post-operative pain, and therefore earlier mobility after the operation and as a result fewer chest and clot related complications. The operation involves the use of 3 or 4 small cuts through which a telescope and specialised instruments are passed which allow the operation to be performed with the benefit of magnification on a TV screen.