It can be applied to treat both nonfunctioning and functioning (hormonally active) tumors, the latter of which include:
There is no established upper size limit to the types of tumors that can be removed laparoscopically – this is generally determined by the experience of the surgeon (3).
Patients who have had previous abdominal surgery are still eligible to undergo laparoscopic adrenalectomy in most cases.
At UCLA, we have successfully removed tumors >7 cm in diameter using the laparoscopic approach without event.
The operation is performed under a general anesthetic, with the patient positioned lying on one side. Four 10 mm (3/8 in.) laparoscopic ports are placed just beneath the rib cage on the same side as the tumor.
A fiberoptic camera is used to guide the operation, which typically lasts 1.5 to 2.5 hours.
Most patients experience little pain and are able to leave the hospital 1-2 days after surgery, though this varies depending on the type of adrenal tumor being treated.Full recovery is rapid.
Patients undergoing laparoscopic adrenalectomy experience:
Patients are generally able to return to work 1 week after surgery.
1. Smith CD, Weber CJ, Amerson JR: Laparoscopic adrenalectomy: new gold standard. World J Surg, 23: 389-396, 1999.
2. Lal G, Duh QY: Laparoscopic adrenalectomy--indications and technique. Surg Oncol, 12: 105-123, 2003.
3. Shen WT, Sturgeon C, Clark OH, et al.: Should pheochromocytoma size influence surgical approach? A comparison of 90 malignant and 60 benign pheochromocytomas. Surgery, 136: 1129-1137, 2004.
4. Toniato A, Bernante P, Rosse GP, et al.: Laparoscopic versus open adrenalectomy: outcome in 35 consecutive patients. Int J Surg Investig, 1: 503-507, 2000.