Laparoscopic Adrenalectomy
Indications
The adrenal gland produces several hormones that circulate throughout the bloodstream to help regulate blood pressure, sugar level, and salt production. When these hormones are produced in excess they can cause imbalances in the body. An adrenal gland that produces too much of anyone's hormone often requires removal. Another reason to remove the adrenal gland is suspicion of cancer. Humans have two adrenal glands and can survive normally with one.
Procedure
Several laparoscopic techniques have been developed for removing the adrenal gland. The choice of which to use is based on the size and location of the adrenal gland. Common to all procedures is the use of four laparoscopic ports, a camera, and specialized instruments used to free the adrenal from its surrounding structure and to clip the adrenal artery and vein. Removing the adrenal can be particularly challenging because of its close proximity to vital structures such as the vena cava, pancreas, liver, and spleen. Prior to the advent of laparoscopic removal of the adrenal gland, large incisions were required to prevent injuring these vital structures while the gland was removed.
Results
The success rates of laparoscopic adrenalectomy have been excellent, approaching 95 percent. The operation takes about two to three hours; hospital stay is only a few days, and postoperative pain is significantly less than with the older, open technique. Note, however, that significantly large glands and those producing volatile hormones may still be removed more safely by using the open technique.