Minimally Invasive Adrenal Surgery
What is the traditional approach to adrenal surgery?
Using a traditional approach, the abnormal adrenal gland is removed through a large (15-20cm) abdominal or flank incision (surgeon’s choice). Excision of the adrenal gland through a flank incision often requires removal of the lowest or 12th rib.
What are the disadvantages of the traditional approach to parathyroid surgery?
Larger incisions are more painful and less cosmetically appealing. Post-operative pain (especially after rib removal) is quite significant and patients’ often require large amounts of post-surgery narcotic drugs (pain killers). Intestinal dysfunction (bowel paralysis leading to bloating, nausea, and vomiting) is caused by narcotic use and can necessitate a 5-7 day hospital stay. Return to work is delayed as the pain from larger incisions can last 3-4 weeks. Many patients require more than a month recovery period before returning to their job.
What is Minimally Invasive Adrenal Surgery?
Minimally invasive or laparoscopic adrenalectomy is a method for removing abnormal adrenal glands using small (less than 2 cm) abdominal incisions. The procedure is performed with a small video camera (laparoscope) and long, thin instruments each introduced into the abdomen through separate small cuts. Using the video camera for visualization, the surgeon separates the adrenal gland from surrounding tissue using an ultrasonic dissector and then removes the abnormal gland through one of the laparoscopic incisions.
What are the benefits of Minimally Invasive Adrenal Surgery?
Small incisions are less painful and are cosmetically superior.
Less post-operative pain translates into a reduced need for narcotic pain medication and quicker return of bowel function.
Most patients are discharged to home within 24 to 48 hrs of surgery and can return to regular activity in only one week.
What are the complications of Minimally Invasive Adrenal Surgery?
Minimally invasive and open surgeries share many of the same complications. These include bleeding and injury to other structures in the abdomen. Minimally invasive surgeries, however, have a lower risk of wound complications such as infection or hernias.
Is surgery safe if my adrenal tumor is hormone producing?
Careful, pre-operative screening of the blood and urine can identify tumors that produce abnormally high levels of specific hormones. Recognition and pre-operative treatment of excess hormone production allows for a safe and uneventful surgery. Lack of pre-operative planning, by endocrinologists and surgeons with limited experience in adrenal surgery, is fraught with increased risks of bleeding, stroke, heart attack, and even death.
How do Ft. Lauderdale Endocrine Surgery (FTLES) physicians optimize my surgical experience?
The experienced physicians at FTLES combine intensive pre-operative screening and careful surgical planning with minimally invasive adrenalectomy techniques. The result is a safe surgical experience with limited post-operative discomfort and early return to normal function.
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