Laparoscopic adrenalectomy is performed to surgically remove one (unilateral adrenalectomy) or both (bilateral adrenalectomy) adrenal glands.
How is Laparoscopic Adrenalectomy performed: before, during and after.
Adrenalectomy is performed by both urologists and general surgeons. General anaesthesia is used before surgery. Three tiny (1 cm) incisions in the belly are made during surgery. Through these keyhole incisions, a telescope and other tiny equipment are placed in the belly, allowing the surgeon to release and dissect the damaged adrenal gland without having to put their hands into the abdomen.
The adrenal gland is then put in a plastic bag and extracted intact from one of the existing incision sites. The procedure usually takes three to four hours to complete. After surgery, medication can be used to restore vital hormones. Most people recover in two to three weeks.
Cost of Laparoscopic Adrenalectomy
In India, the average cost of laparoscopic surgery ranges from Rs. 33,250 to Rs. 65,500. The rates, however, may vary depending on hospitals and the city.
| Description | Cost |
|---|---|
|
Cost of surgery in India |
Rs. 50,000 |
|
Cost of surgery in Hyderabad |
Rs. 45,000 |
| Description | Cost |
|---|---|
|
Number of days in the hospital |
3-4 |
|
Type of surgery |
Minor |
|
Anaesthesia type |
General |
|
Recovery |
10 Days |
|
Duration of the procedure |
1 hour |
|
Surgery |
Minimally invasive |
Risks and complications of Laparoscopic Adrenalectomy
There are multiple risks associated with adrenalectomy. Intraoperative complications may include vascular injury, excessive bleeding, and organ injury. Postoperative complications could take the form of asthma, mild paralytic ileus, wound infection, contralateral atelectasis, and retroperitoneal haematoma.
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Frequently Asked Questions about Laparoscopic Adrenalectomy
A suspicion of malignancy or malignant tumours, non-functional tumours with a risk of malignancy, and functional adrenal tumours are all reasons for adrenalectomy. The majority of adrenal tumours are non-cancerous. If the tumour releases too many hormones or is huge, surgery is needed to remove it. Adrenalectomy may also be required to remove cancer that has spread from another organ, such as the kidney or lung.
Adrenalectomy is a general, minimally invasive surgery. However, complications are possible with any surgical operation. When compared to laparoscopic adrenalectomy, complications are more common with open adrenalectomy. General patients are monitored for bleeding, blood clots, infection or damage to nearby organs in major cases.
Overall, recovery can take two to four weeks, and open adrenalectomies can take even longer. If both adrenal glands were removed or if the remaining adrenal gland is not functioning correctly, patients are supposed to take steroids. Because these steroids are life-saving and supposed to be consumed for life, they should never be stopped without medical advice. It is also advised that patients avoid excessive stress and lifting weights.
Most patients stay in the hospital for a day or two. Patients may have sluggish intestines for many days following the surgery as a result of the anaesthesia. Suppositories and stool softeners are frequently administered to help with this issue. Patients are under observation for 24 to 48 hours.
As the adrenal glands are involved in stress reactions and blood pressure management, blood pressure must be closely monitored using an arterial line or blood pressure cuff. Electrolytes, particularly potassium, must be closely monitored. The post-anaesthesia care unit nurse must also keep a watchful eye on the patient for indicators of an acute haemorrhage. The nurse evaluates the patient’s degree of discomfort and administers pain medication as needed. Unlike with open adrenalectomy, there is usually no need for patient-controlled analgesia.
Adrenal tumours are growths on the adrenal glands that can be malignant, cancerous, or non-cancerous. The majority of adrenal tumours have no recognised aetiology. All three Carney complexes, Li-Fraumeni syndrome, multiple endocrine neoplasia type 2, and neurofibromatosis type 1 are all risk factors for adrenal tumours. Tumors can occasionally cause life-threatening high blood pressure. Although tumours are an uncommon cause of high blood pressure, they must be considered when medication does not achieve the desired results.
After surgery, the patient will be in pain for a week or two. The recovery period after open adrenalectomy is substantially longer, and patients can expect to be out of commission for four to six weeks.
After laparoscopic adrenalectomy, patients have minimal pain, typically managed with non-narcotic pain relievers such as Tylenol or ibuprofen. Patients who have had open adrenalectomy may require narcotic pain relief.
Stop using some medications, particularly nonsteroidal anti-inflammatory drugs, since they might cause blood coagulation problems. Your doctor may recommend medicine to help manage your blood pressure and heart rate if you have hypertension. Your doctor will give you detailed instructions on when to cease eating, drinking, and taking medicines. You must follow these recommendations for your safety, and you must have an empty stomach before any surgical treatment that needs anaesthesia. Your adrenal surgery may be cancelled if you do not follow the doctor’s recommendations.
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