Our Summary

This study looks at the use of robots in surgery to remove adrenal tumors. The researchers reviewed the medical records of 37 patients who had this type of surgery between 2010 and 2020. They found that 65% of these operations were done on the left adrenal gland, and the average time spent in the operating room was 213 minutes. On average, the adrenal glands removed were about 71 cubic centimeters in size, and about 74 milliliters of blood was lost during surgery. Patients typically stayed in the hospital for just over a day after their operation.

The study also revealed that there was no significant difference in outcomes between surgeries on the right and left adrenal glands. About a third of the patients had a type of adrenal tumor called an adrenal cortical adenoma, and only one patient had a more serious type of adrenal cancer. Four patients had complications after surgery that required them to be readmitted to the hospital, and there was one death.

In conclusion, while the standard treatment for most adrenal tumors is a different type of minimally invasive surgery (laparoscopic resection), this 10-year study suggests that robotic surgery can also be very effective and useful in both community and academic hospitals.

FAQs

  1. What percentage of the adrenalectomy surgeries in the study were performed on the left adrenal gland?
  2. Was there a significant difference in outcomes between surgeries on the right and left adrenal glands according to the study?
  3. How does the study compare the effectiveness of robotic surgery to laparoscopic resection for adrenal tumors?

Doctor’s Tip

A helpful tip a doctor might tell a patient about adrenalectomy is to discuss with their healthcare provider about the different surgical options available, including robotic surgery, and to ask about the potential benefits and risks of each option. It is important to have a thorough understanding of the procedure and what to expect during recovery in order to make an informed decision about the best course of treatment for their specific situation. Additionally, following post-operative instructions carefully and attending follow-up appointments are essential for a successful recovery after adrenalectomy.

Suitable For

Patients who are typically recommended adrenalectomy include those with adrenal tumors, such as adrenal cortical adenomas or adrenal cancer. Adrenalectomy may also be recommended for patients with hormone-producing tumors that are causing symptoms or complications, such as pheochromocytomas or aldosteronomas. Additionally, patients with large adrenal tumors or tumors that are suspicious for malignancy may also be candidates for adrenalectomy. Overall, the decision to recommend adrenalectomy will depend on the specific characteristics of the tumor and the patient’s overall health and medical history.

Timeline

Before adrenalectomy:

  1. Patient presents with symptoms such as high blood pressure, weight gain, muscle weakness, or hormonal imbalances.
  2. Diagnostic tests such as blood tests, imaging studies, and possibly a biopsy are performed to confirm the presence of an adrenal tumor.
  3. Patient consults with a surgeon to discuss treatment options, including adrenalectomy.
  4. Pre-operative preparations are made, including blood tests, medication adjustments, and fasting.

After adrenalectomy:

  1. Patient undergoes robotic adrenalectomy surgery, typically lasting around 213 minutes.
  2. The adrenal tumor is removed, and the patient may experience some pain and discomfort post-operatively.
  3. Patient stays in the hospital for just over a day for monitoring and recovery.
  4. Follow-up appointments are scheduled to monitor recovery and assess for any complications.
  5. Patients may experience improved symptoms related to the adrenal tumor, such as normalization of blood pressure.
  6. Long-term follow-up is necessary to monitor for any recurrence of the tumor or development of new adrenal issues.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with adrenalectomy?
  2. How long is the recovery process after adrenalectomy?
  3. Will I need to take any medications or make any lifestyle changes after the surgery?
  4. Are there any alternative treatment options for my adrenal tumor?
  5. How long have you been performing adrenalectomies, and what is your success rate?
  6. Will I need any additional tests or imaging before the surgery?
  7. How will my adrenal function be affected after the surgery?
  8. What type of anesthesia will be used during the surgery?
  9. How often will I need follow-up appointments after the surgery?
  10. Are there any long-term effects or risks associated with having one adrenal gland removed?

Reference

Authors: Francis A, Mellert L, Parekh N, Pozsgay M, Dan A. Journal: JSLS. 2022 Jan-Mar;26(1):e2021.00083. doi: 10.4293/JSLS.2021.00083. PMID: 35444401