Laparoscopic Adrenelectomy
Laparoscopic Adrenalectomy is a minimally invasive surgical procedure to remove one or both adrenal glands. It is commonly performed to treat adrenal gland disorders caused by tumors, overactive glands, or other abnormalities.
Indications
Laparoscopic adrenalectomy is recommended for:
- Adrenal tumors: Both benign (e.g., adenomas) and malignant tumors.
- Hormone-producing conditions:
- Cushing’s syndrome (excess cortisol production).
- Pheochromocytoma (adrenaline-producing tumor).
- Aldosteronism (excess aldosterone production).
- Large or suspicious adrenal masses.
- Metastatic cancer involving the adrenal gland.
Procedure Overview
Preparation:
- Preoperative evaluation: Includes CT scans, MRIs, hormonal tests, and sometimes PET scans.
- Medication: Patients with pheochromocytoma may require preoperative medications to control blood pressure.
- Anesthesia: General anesthesia is used.
Surgical Steps:
- Positioning: The patient is placed in a lateral decubitus position (side-lying).
- Trocar placement: Small incisions (typically 3-5) are made in the abdomen or back to insert trocars.
- Insufflation: Carbon dioxide gas inflates the abdominal cavity for better visibility and maneuverability.
- Adrenal gland removal: Using laparoscopic instruments, the surgeon carefully dissects and removes the adrenal gland, taking care to avoid nearby structures (e.g., kidney, blood vessels).
- Specimen retrieval: The gland is removed through one of the trocar sites, sometimes using a specialized retrieval bag.
- Closure: Incisions are closed with sutures or adhesive strips.
Postoperative Care:
- Monitoring of vital signs and hormone levels.
- Pain management and gradual reintroduction of activity.
- Hormone replacement therapy, if both glands are removed.
- Follow-up visits to evaluate recovery and manage any complications.
Benefits:
- Smaller incisions, resulting in less scarring.
- Shorter hospital stay and faster recovery.
- Reduced postoperative pain.
- Minimal risk of complications compared to open surgery.
Risks and Complications:
- Bleeding or infection.
- Damage to nearby organs or blood vessels.
- Hormonal imbalances if the adrenal gland removal is incomplete or excessive.
- Rarely, deep vein thrombosis (DVT) or complications from anesthesia.
