Laparoscopic Adrenalectomy for adrenal tumors | Steps, Recovery, And Advantages

What are Adrenal Glands?

Adrenal glands, also termed suprarenal glands, are the small yellow-bronzed triangular-shaped masses located at the top of each kidney. These glands are specialized for producing specific hormones such as estrogen, progesterone, cortisol, cortisone, steroids, and certain chemicals such as epinephrine, norepinephrine, and dopamine. All these hormones are assigned different tasks to perform, such as they help to regulate the metabolism, blood pressure, immune system, response to depression and stress, and some other essential functions of the body. They are usually found at the back wall of the abdomine -the retroperitoneum. So, the Adrenalectomy for adrenal tumors can remove this. Now let’s take a look at what is the function of Adrenal Glands.

The Function of Adrenal Glands

The primary function of adrenal glands is to produce the essential hormones that control the body fluids, salt regulation, blood pressure, muscle development, sugar metabolism, and sexual desire and development. They are also a source of essential chemicals such as epinephrine, also called adrenaline. When adrenal glands don’t produce any of their hormones properly, it may lead to adrenal inefficiency. In addition, the Abnormal activity of adrenal glands has carcinogenic tumors. These tumors may be benign or malignant, stimulating the production of many other unhealthy and unwanted hormones that may lead to various health risks. Thus, laparoscopic surgery of such infected and tumored adrenal glands is highly recommended.

Laparoscopic Adrenalectomy – Gold Standard

Like kidneys, our body can also work generally without one adrenal gland. The surgical removal of one adrenal gland from the top of the kidney is known as an adrenalectomy. The laparoscopic removal of one of the adrenal glands using the advanced and latest techniques of the laparoscope is known as Laparoscopic Adrenalectomy. Therefore, this laparoscopic surgery has become the gold standard technique for removing carcinogenic adrenal glands or secretory tumors. Therefore, laparoscopic and bariatric surgery is highly admirable for the laparoscopic removal of cancer-causing and diseased adrenal glands.

When to choose Laparoscopic Adrenalectomy?

Adrenalectomy is carried out for many reasons, but most importantly, this procedure is done to expel the abnormal or cancer-causing adrenal glands. Mostly the adrenal glands are removed because of their abnormal production of chemicals such as cortisol, epinephrine, norepinephrine, and aldosterone. This abnormal activity of the adrenal glands brings out many medical discomforts such as hypertension, obesity, migraines, palpitations, and facial flushing. Sometimes these infected adrenal glands become tumors benign or malignant. Therefore, laparoscopic surgery of such adrenal tumors is highly suggested to keep you cancer-free. Laparoscopic surgery of carcinogenic adrenal glands or tumors is highly recommended in specific medical conditions such as Conn’s tumor and sporadic pheochromocytoma. These are the two benign tumor conditions in which these tumors secrete a hormone that elevates the patient’s blood pressure to a much higher level, leading him to fatal health risks. It is also a successful treatment for other hormonally inactive tumors found when observing other medical complications.

Before Laparoscopic Surgery Preparations

If you are having a laparoscopic surgery of your unhealthy and infected adrenal glands, you need to follow some preparatory steps, for example;

• Blood tests including CBC (complete blood count)
• Chest X-ray
• An electrocardiogram (EKG)

If you are suffering from hypertension, your doctor must give you some medications to maintain your blood pressure and heart rate. You are empty stomach before the operation is the foremost requirement for this laparoscopic surgery. The expert surgeon in laparoscopic and bariatric surgery will guide you about the special instructions about your diet schedule and medications before your laparoscopic surgery. It will be beneficial for you to follow up on all these instructions before the surgery. It would be best to be on an empty stomach before the surgery starts because this might require anesthesia.

Basic Procedure of Laparoscopic Adrenalectomy

Laparoscopic adrenalectomy is a surgical procedure specifically designed to expel sick and cancer-causing adrenal glands out of the body. The removal of the diseased adrenal gland from the body using a laparoscopic technique requires specialized skills and trained hands. The laparoscope is the most technical instrument that provides a better internal view of adrenal glands and their surroundings through small keyhole incisions rather than large and open abdomen surgery.

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Steps of Laparoscopic Adrenalectomy

The fundamental step of laparoscopic surgery of ailing adrenal glands is making small incisions in the abdomen. Almost three small incisions are made, each of 1cm at three different dimensions. After the incisions, a laparoscope is inserted into the stomach through one of these minor cuts. The laparoscope is a special telescope aided with a tiny camera attached at one end of this telescopic tube. The surgeon monitors the whole internal view through the laparoscope onto his screen and separates the diseased adrenal gland through his instrument via keyhole incisions without inserting his hands. The isolated glands are then packed in a bag and broken into small pieces, then expelled out of the body.

The surgical approaches towards Laparoscopic Adrenalectomy

Three surgical approaches are generally made towards this surgical technique of laparoscope.

• Lateral transperitoneal technique
• Lateral retroperitoneal technique
• Posterior technique

All these techniques are commonly used during this procedure.

Recovery after Laparoscopic adrenalectomy

You can eat, drink normally, and have regular meals just right after the day of surgery. However, if you want to eat and drink just like your everyday routine, you have to visit your surgeon on the decided days and take your prescriptions seriously. In addition, to avoid any blood clots formation, you will be asked to go for walks regularly. The duration of your hospital stay depends upon your condition and your willpower. Although most people get ready to go home within one or two days of the surgery, some might take pain killers to relieve the pain over the site of incisions. If your adrenal tumors were carcinogenic, then you need to follow up on all the prescribed testing to check if all the cancerous tumor was removed or not. And if your adrenal tumor was functional, then you need to go for regular appointments with your best bariatric surgeon to check if your hormonal level is still maintained or not.

Laparoscopic Adrenalectomy is Safe for Obese Patients

Laparoscopic Adrenalectomy for adrenal tumors is found to be a very safe and feasible surgery for obese patients. A sharp and definite weight loss has been in the obese patients even with Cushing syndrome who undergo the laparoscopic surgery of adrenal tumors. In addition, obese patients have shown a significant drop in their weight after the surgical removal of adrenal glands. So it can also be the best weight loss surgery.

Advantages of Laparoscopic Adrenalectomy 

A few of the advantages of laparoscopic adrenalectomy are listed below;

• A safe and effective method: Laparoscopic adrenalectomy provides the most effective and secure way for laparoscopic surgery of adrenal glands or malignant tumors.

• Minimally invasive procedure: This advanced laparoscopic technique is quite minimally invasive. No significant and open incisions are made for the removal of diseased adrenal glands. Instead, only small and more minor incisions, almost 3-4 cuts are made on the front or back wall of the abdominal tissues.

• Less time-consuming and laborious method: It is a less time taking operating procedure. The laparoscopic removal of sick adrenal glands is quick compared to open surgery and less strenuous methods. It takes almost 3-4 hours for the surgery.

• Fast and quick recovery: The recovery time after this surgical removal of the tumor is relatively short and sharp compared to open surgery.
• Short time to regular diet and routine life: The patient can enjoy his typical meal and everyday work after 2-3 weeks of surgery.
• Less duration of hospital stays: This laparoscopic removal of septic adrenal glands or tumors offers you fewer hospital days, and you can go home after 1-2 days of operation.
• More minor postoperative pains and discomforts: It offers you fewer pains and aches after your surgery is done, and you face less physical disability after an operation.
• Minimum blood loss: No excessive loss of blood happens in this surgical method.
• The cost-effective surgical procedure: The adrenalectomy’s surgical process using the advanced and latest laparoscopic techniques is highly cost-effective, and you can get the medical solution to your problem within your budget.
• Technically an advanced and latest surgical method: Laparoscopic adrenalectomy is the most advanced surgical removal of tumored adrenal glands using the newest equipment and techniques.
• Similar results to open surgery: This laparoscopic surgery of ailing adrenal glands gives identical results to open surgery or extensive incision surgery.
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Complications after Laparoscopic Adrenalectomy

The patient may also encounter some of the complications after the laparoscopic surgery of adrenalectomy as;

• Bleeding: Minimal blood loss has been seen during this surgical procedure, but almost 5% of the patients need blood transfusions during the operation.

• Infections: Before the surgery, all the patients are given antibiotics intravenously to avoid illness in the body after the surgery. But some patients may feel symptoms of infections after the surgery is completed, such as fever, urinary obstruction, body aches, or pains at incisions.

• • Pain after the surgery: After the retroperitoneoscopic adrenalectomy or laparoscopic adrenalectomy, you may feel pain at the site of incisions. Sometimes the pain may be controllable, but it becomes impossible for the patient to bear it in some situations, especially in bilateral adrenalectomy.

• Organ or tissues injury: uncommonly, the nearby tissues or organs may injure during the surgical attempt. These surrounding tissues may include the bowel, spleen, liver, pancreas, kidney, gall bladder, or other vascular structures. In addition, this injury may consist of muscles or nerves injury depending upon the position and site of surgery.

• Hernia: Once the surgery is completed, all the incisions made during the laparoscopic surgery of adrenal glands are carefully closed, but there are still the chances of hernia complication.

• Conversion to significant open surgery methods: During this laparoscopic procedure, the surgery may be converted to open operation from the laparoscopic surgery.

Adrenal Disorders for Laparoscopic Adrenalectomy

Following would be the conditions or adrenal disorders that will suggest you laparoscopic surgery of adrenal glands.

• Adrenal inefficiency
• Congenital adrenal hyperplasia
• Overactive adrenal glands
• Cushing syndrome
• Hyperaldosteronism
• Pheochromocytoma
• Adrenal cancers

When is the open surgery for adrenalectomy recommended?

Open surgery for the adrenalectomy is usually recommended when the adrenal tumors become malignant tumors. These malignant adrenal tumors begin to grow uncontrollably and may start to spread over within the other body organs or parts and become life-threatening. The open Adrenalectomy for adrenal tumors is also an excellent step to take in some specific medical conditions when there is a high risk of adrenal cancer and produce 4-7cm sized tumors that may spread in the body. Numerous endocrine neoplasia also needs an open procedure for adrenal removal as both sides can be inspected simultaneously with keen observation. While the laparoscopic surgery for adrenal glands is based on a small incised location for the treatment to carry out, the surgeon cannot operate other invading organs in case of widespread malignant adrenal tumors.

Cost Analysis of Laparoscopic Adrenalectomy

Operative costs of laparoscopic surgery of adrenal glands should not become a factor, as this is the most cost-effective laparoscopic and bariatric surgery technique. The primary goal of  surgeon is Adrenalectomy for adrenal tumors  which give you complete compliance and satisfaction with cost-friendly health care services regarding your medical condition. Moreover, the laparoscopic surgery of your adrenal tumors is the one-step solution to your prevailing cancer. Therefore, getting this within the effective cost is the primary purpose of such advanced laparoscopic and bariatric surgery procedures. Laparoscopic and bariatric surgery is not complex surgery, but it demands highly skillful hands for the operation and gives you a healthy life over hopelessness. Therefore, this cost doesn’t matter, but the best medical treatment, health care services, and ultimately an ideal life. Therefore, when you opt for laparoscopic surgery of diseased and health-hazardous adrenal glands, you need to be worried about the cost. The whole package of this treatment includes the price of surgery, health care facilitation, operating room, and hospital stay.

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