Our Summary

This research paper talks about a less invasive operation used to remove non-cancerous tumors from the adrenal glands, a pair of glands located on top of your kidneys. They discuss how to choose patients for this surgery and how to conduct the operation using two methods - one which involves entering through the abdomen and another that involves accessing the glands from the back. Both techniques are less invasive and have fewer complications than traditional surgery.

FAQs

  1. What is the gold standard for removal of benign adrenal tumors?
  2. What are the factors discussed in patient selection for laparoscopic transabdominal and posterior retroperitoneoscopic adrenalectomy procedures?
  3. What details of the surgical technique are discussed for both laparoscopic and posterior retroperitoneoscopic adrenalectomy procedures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to follow the pre-operative preparation instructions closely, which may include fasting before the surgery and stopping certain medications. This will help ensure a successful procedure and optimal recovery.

Suitable For

Patients who are typically recommended for adrenalectomy include those with adrenal incidentalomas, adrenal metastases, and benign adrenal tumors. Adrenalectomy is often recommended for patients with symptomatic adrenal tumors, hormone-producing tumors such as aldosteronomas, cortisol-producing tumors such as Cushing’s syndrome, and catecholamine-producing tumors such as pheochromocytomas. Patients with large adrenal tumors, tumors that are suspicious for malignancy, or tumors causing symptoms such as pain, hypertension, or hormonal imbalances may also be candidates for adrenalectomy. Minimally invasive techniques such as laparoscopic transabdominal and posterior retroperitoneoscopic approaches are now considered the gold standard for removal of benign adrenal tumors.

Timeline

Before adrenalectomy:

  • Patient may experience symptoms such as high blood pressure, weight gain, muscle weakness, and hormonal imbalances
  • Imaging studies such as CT scans, MRI, and PET scans may be done to locate and determine the size of the adrenal tumor
  • Blood tests may be performed to check hormone levels and assess the functionality of the adrenal gland

After adrenalectomy:

  • Patient may experience pain and discomfort at the surgical site
  • Hospital stay typically ranges from 1-3 days
  • Patient will be monitored for any complications such as bleeding, infection, or adrenal insufficiency
  • Recovery time can vary but most patients can return to normal activities within a few weeks
  • Follow-up appointments will be scheduled to monitor hormone levels and ensure the success of the surgery

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing an adrenalectomy for my specific condition?
  2. Will I need any additional tests or evaluations before the surgery?
  3. What is the success rate of minimally invasive adrenalectomies for benign adrenal tumors?
  4. How long is the recovery process and what can I expect in terms of pain and discomfort post-surgery?
  5. Are there any long-term effects or complications associated with adrenalectomy?
  6. Will I need to take any medications or make lifestyle changes after the surgery?
  7. How often will I need follow-up appointments or monitoring after the procedure?
  8. What are the alternatives to adrenalectomy and why is this the recommended treatment for me?
  9. How experienced are you in performing adrenalectomies, and what is your success rate with this procedure?
  10. Can you explain the difference between laparoscopic transabdominal and posterior retroperitoneoscopic approaches and why one may be more suitable for me than the other?

Reference

Authors: Carr AA, Wang TS. Journal: Surg Oncol Clin N Am. 2016 Jan;25(1):139-52. doi: 10.1016/j.soc.2015.08.007. Epub 2015 Oct 31. PMID: 26610779