Laparoscopic adrenalectomy is a minimally invasive technique, which provides patients with less discomfort and equivalent results when compared to the larger incision required with traditional open surgery. When compared to conventional open surgery, laparoscopic adrenalectomy has resulted in significantly less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes identical to that of open surgery.
Laparoscopic adrenalectomy is performed under general anesthesia. The typical length of the operation is 1.5-2 hours. The surgery is performed through 3 or 4 small (1cm) incisions made in the abdomen. A telescope and small instruments are inserted into the abdomen through these keyhole incisions, which allow the surgeon to completely free and dissect the diseased adrenal gland. The adrenal gland is then placed within a plastic bag and removed intact through an extension of one of the existing incision sites. The average length of stay of patients following laparoscopic adrenalectomy is 1.5 days.
Image 1. Laparoscopic Left Adrenalectomy. Following exposure of the adrenal gland, the adrenal vein is identified, dissected and ligated.
While most adrenal tumors can be removed laparoscopically, certain adrenal tumors should be removed through a traditional open operation. Larger tumors (usually over 10 to 15 centimeters in size) and tumors that are thought to be adrenocortical cancer are usually removed through an open operation. Patients undergoing open adrenalectomy often remain in the hospital for a few days after the operation.