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Laparoscopic Adrenalectomy

Laparoscopic adrenalectomy (LA) was first described by Gagner et al. in the early 1990s, and has since become the gold standard for removal of small and medium sized adrenal tumors.

Most commonly, LA is performed for unilateral benign adrenal lesions, however the minimally invasive technique is also routinely used for bilateral disease, as well as myelolipomas, adrenal cysts, adrenal hemorrhage and androgen-secreting tumors.  Compared with the open approach, LA offers shorter hospital stay, improved patient satisfaction, decrease post-operative pain and markedly improved cosmesis.  Even more, the difficulty in obtaining adequate open surgical exposure, combined with the diminutive size of the adrenal gland make laparoscopy an especially attractive option. Given this, we decided to proceed with LA approach for our patient who presented with NSCLC metastasis to his right adrenal.

DOI# http://dx.doi.org/10.17797/4ek02iupxd

Mellon MJ, Sethi A, Sundaram CP. Laparoscopic adrenalectomy: Surgical techniques. Indian Journal of Urology : IJU : Journal of the Urological Society of India. 2008;24(4):583-589. doi:10.4103/0970-1591.44277.

Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med. 1992;327:1033.

laparoscopic adrenalectomy
small and medium sized adrenal tumors
any contraindication to laparoscopy
left lateral decubitus with appropriate pressure padding
cross sectional imaging and routine preoperative lab work
psoas muscle, diaphragm, inferior vena cava (IVC), adrenal vein and artery, kidney with Gerota's fascia
laparoscopic advantages include less post operative pain and shorter length of stay
general concerns of bleeding, infection and damage to nearby organs, with operative-specific injuries to the IVC, liver and diaphragm
general concerns of bleeding, infection and damage to nearby organs, with operative-specific injuries to the IVC, liver and diaphragm
NYU Langone Dept of Surgery
Mellon MJ, Sethi A, Sundaram CP. Laparoscopic adrenalectomy: Surgical techniques. Indian Journal of Urology�¢ï¿½�¯: IJU�¢ï¿½�¯: Journal of the Urological Society of India. 2008;24(4):583-589. doi:10.4103/0970-1591.44277. Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma. N Engl J Med. 1992;327:1033.

Review Laparoscopic Adrenalectomy.

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