Depending on the circumstances, sometimes a surgeon will need to use a different surgical technique on one patient and another operation on a second patient who are battling the same condition. For example, a technique to remove one person’s kidney tumor may not be viable for someone else’s kidney tumor. Because of this, medical experts have created multiple techniques to address similar issues. Today, we take a look at five different types of adrenalectomy operations, and we explain why these techniques may be used.
Laparoscopic Adrenalectomy
The laparoscopic or minimally-invasive approach for an adrenal resection is performed to address small or moderately sized tumors. This preferred technique is generally associated with the lowest amount of postoperative pain and the shortest post-op stay in the medical facility. The surgeon addresses the adrenal gland through a series of small incisions through which medical tools and a camera are guided.
Standard Trans-Abdominal Adrenalectomy
This approach involves the surgeon making an incision on the anterior abdominal wall and moving the bowels and other organs out of the way to access the kidney. This allows the doctor to have a better view of the surrounding organs and major blood vessels, which is key during surgery. It is the preferred method if it is unclear if the tumor is cancerous prior to the operation.
Thoraco-Abdominal Adrenalectomy
This technique is beneficial because it allows the greatest exposure to the adrenal gland and the nearby structures. However, it also involves making a large incision along the patient’s side. This large open operation is only reserved for the largest cancerous tumors. This is done to provide the most exposure of the tumor to ensure it is fully removed, and in order to achieve necessary blood flow in the region.
Posterior Adrenalectomy
As the name implies, a posterior adrenalectomy involves making an incision on the patient’s back in order to address the adrenal gland. Because this technique doesn’t offer great exposure of nearby organs or blood vessels, this operation is reserved for small tumors. Similar to the laparoscopic approach, this procedure has low levels of reported pain, and patients can generally be discharged within a couple of days, but unfortunately it’s not for everyone.
Retroperitoneal Adrenalectomy
This is a hybrid approach that combines elements of the posterior and trans-abdominal operations. It is beneficial because it aims for lower levels of post-op pain, similar to the posterior approach, but it also involves better organ and blood vessel exposure as noted in the transabdominal technique. The patient is placed on their side and an incision is made. The surgeon then exposes the kidney, adrenal gland and important blood vessels but avoids entering the abdominal cavity (eases post-op pain). However, this technique is reserved for benign tumors, and is not the optimal route for malignant masses.
As we noted above, there are a number of different reasons why one technique may be preferred over another, but other factors also influence what approach may be used. Aside from the reasons listed in each technique section, a surgeon will always take these factors into consideration before determining an optimal approach:
- Size of tumor
- Type of tumor (benign/malignant)
- Any irregularities noticed on imaging techniques
- History of previous surgeries
- The surgeon’s experience with each technique
For more information on adrenalectomy operations or to schedule an appointment in the Twin Cities, contact Dr. Koeplin today.
