Minimally invasive (laparoscopy) surgery techniques
Most adrenal disease requiring surgery can be done using minimally invasive (laparoscopy) surgery techniques. Laparoscopic adrenalectomy is the preferred technique for non-cancerous adrenal disease, including the following:
- Aldosterone-secreting adrenal tumors (Conn's syndrome)
- Cortisol-secreting adrenal tumors (Cushing's syndrome)
- Adrenalin-producing adrenal tumors (Pheochromocytoma)
- Primary adrenal hyperplasia
- Adrenal hyperplasia after failed treatment of Cushing's disease
- Large nonfunctioning adrenal tumors (<10-12cm)
- Adrenal metastasis
The operation is performed using small skin incisions and a camera called a laparoscope.
Patients are usually place on their left or right side depending on which gland is been removed. Three to five small incisions (cut) are typically made under the rib cage. Operative ports called trocars are placed. Using these ports, a camera and surgical instruments are placed into the abdomen.
The camera projects the inside of the patient's abdomen onto a television monitor. The surgeon performs the operation while looking at a television monitor. Once the adrenal gland is freed, it is placed in a bag and removed through one of the very small skin incisions.
Laparoscopic adrenal surgery has become the standard of care for most diseases of the adrenal gland. Compared to open adrenal surgery, laparoscopic adrenal surgery has several benefits, including:
- Less pain after surgery
- Less pain medication
- Smaller scars
- Less wound complications (wound infection, abscess)
- Faster return of bowel function
- Shorter hospital stay (1-2 days versus 5-7 days)
- More rapid recovery (2 weeks versus 4-8 weeks)
- Earlier return to work and other activities
- Less overall complications.