Recent improvement of diagnostic methodology and techniques, preoperative medical management, increasingly precise radiological localization, better anesthesia and most notably refined laparoscopic surgical techniques have joined hands to push laparoscopic adrenalectomy into the mainstream of surgery-based cancer care. Laparoscopic removal of affected tissue has become the standard adrenal cancer treatment. The surgical management of adrenal abnormalities with laparoscopic adrenalectomy is now a safe procedure offering predictable outcomes. It has finally become the preferred option for surgically treating both benign and malignant adrenal masses.
The diagnosis and management of adrenal carcinomas have always been one of the most challenging aspects of any urological practice. Adrenal cancer manifests in a variety of faint and subtle ways, making it difficult for patients to know when to request a screening. But the advent of laparoscopic adrenalectomy offers urologic surgeons an invaluable tool with which to balance those scales and a set of clear-cut benefits to patients suffering from an adrenal carcinoma.
Because of the minimally invasive nature of the procedure, it offers reduced morbidity, better cosmetic results and a lower risk of wound separation or herniation. Laparoscopic adrenalectomy is now the most advantageous surgical option for treating both functioning (abnormal hormone producing) and non-functioning (non-hormone producing) adrenal tumors. The open surgical method can now be reserved for patients with abnormally large adrenal tumors.
Take Advantage of Improved Laparoscopic Techniques
The traditional (or open-surgery) method of removing an adrenal tumor involves a substantial incision into either the front of the abdomen or the lower back. Though not ineffective, both entry points have typically been associated with postoperative pain and a prolonged recovery period. By way of comparison, the laparoscopic approach to adrenalectomy has been shown to reduce the disability and pain associated with major incisions. However, removing an adrenal tumor using laparoscopic tools is an especially demanding procedure. It calls for specialized surgical skills and the training and experience to put it to use.
Laparoscopic adrenalectomy is a minimally invasive technique that involves inserting a tiny telescopic camera system into the surgical site via a keyhole incision in the patient's abdominal wall. This offers surgeons a magnified high-definition view of the stricken adrenal gland and its surroundings, a substantial improvement on the limited prospective available during open-surgical procedures. Once the laparoscopic camera is in place, additional keyhole incisions are made through which the instruments necessary to perform the operation, hold or manipulate abdominal tissue, free portions of the adrenal gland from surrounding tissue then place the tumor into a small bag and withdraw it from the abdomen.
Furthermore, the ability to intra-operatively palpate the tumor during the hand assisted laparoscopic adrenalectomy gives surgeon the flexibility to make an early assessment as to whether or not a mass is benign (non-cancerous) or malignant and of normal or unusual size, and thereafter reverting to an open surgery tact if necessary. When faced with larger than normal tumors, even laparoscopic tools are less desirable. Because of the risk of scattered cancer cells, large adrenal tumors need to be removed both wholly intact and with a shielding-rim of surrounding normal tissue remaining in order to ensure a clean microscopic-free margin around the affected tissue.
- The procedure requires one 0.5 centimeter and two 1-centimeter abdominal incisions.
- Short, 2-3 day post operative hospital stay.
- Less post operative scarring.
- Reduced discomfort and less need for pain medication.
- 2-3 week post operative recovery time before returning to a normal, but non-taxing, level of activity.
Open Surgical Adrenalectomy
- Requires a comparably large cut-in via either the abdomen or back.
- 3-5 day post operative hospital stay.
- More post operative scarring.
- More discomfort and pronounced need for pain medication.
- 6-8 week post operative recovery time before returning to a normal, but non-taxing, activity level.
Open surgery patients can experience greater blood loss, suffer higher chances of infection, and greater risk of other complications, which may require a longer hospital recovery in comparison to those who've undergone laparoscopic surgery.
The Minimally Invasive Laparoscopic Adrenalectomy Might Be Right for You
If you'd like more information on minimally invasive laparoscopic technology, advanced adrenal cancer treatment options or simply need medical advice, please don't hesitate to contact our office.