Laparoscopic Removal of the Adrenal Gland (Adrenalectomy)

Indications

Like the kidney, most humans have two adrenal glands and can survive normally with one. The adrenal gland produces several substances (hormones) that circulate throughout the blood stream to help regulate blood pressure, sugar level and salt production. When produced in excess these substances can cause various illnesses. Indications to remove an adrenal gland includes a functional adrenal mass - a mass growing in the adrenal gland which produces an excess of an adrenal hormone. Large adrenal masses may also require removal if malignancy is expected.

Procedure

Several laparoscopic and robotic techniques have been developed to remove the adrenal gland. The decision of which to use is based on size and location of the adrenal gland. Common to all procedures is the use of laparoscopic ports, a camera and specialized instruments to dissect the adrenal from its surrounding structures and clip the adrenal arteries and vein.

Removing the adrenal can be particularly challenging secondary to its close proximity to vital structure such as the vena cava, pancreas, liver and spleen. Prior to advent of laparoscopic removal of the adrenal gland large incisions were required to gain adequate exposure to prevent injuring these vital structures while removing the gland.

Results

The success rates of laparoscopic adrenalectomy have been excellent. The operation is complex but the hospital stay and post-operative pain is significantly less when compared to the traditional open technique. Note however, significantly large glands and those producing volatile hormones may still be more safely removed using the open technique.

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