Adrenal Tumors - Laparoscopic Adrenalectomy
After a full medical work up, the patient and his surgeon make a decision to remove the diseased adrenal gland after all options are considered. In laparoscopic adrenalectomy, the patient is placed to sleep on the operating table. He/she is then turned onto the side, 3-4 key-hole size incisions are placed on the same side of the body as the kidney tumor. The surgeon’s hands are not inside the patient’s body during surgery. A video camera and long instruments are inserted through these key-hole incisions. The surgeon watches a television monitor which gives him a view of the abdominal cavity. The adrenal gland, which sits on top of the kidney, is exposed. The vein to the adrenal gland is clipped and cut. Then, the gland is carefully released from the surrounding tissues off and removed from the upper part of the kidney. It is then placed in a bag and removed through one of the keyhole incisions. After the operation, the patient is given clear liquids to drink and allowed to walk about the evening of the surgery. On the day following surgery, the patient is eating a full regular diet, and is discharged home. There are numerous advantages to the laparoscopic approach compared to the conventional open approach to adrenalectomy. First, the patient will feel much less pain when compared to open adrenalectomy. This is in part due to the small keyhole incisions compared to an open adrenalectomy, which could result in an 8-12” incisional scar. Another reason for less pain is that no large metal retractors are needed to keep the incision open. Blood loss is almost always minimal; therefore patients will not likely require blood transfusion. Less pain means faster postoperative recovery. Usually, the patients are back to their normal activities within 4 weeks following surgery. In addition to these advantages, the laparoscopic approach also offers a better cosmetic result due to the small and almost negligible incisional scars over time.