Minimally Invasive Surgery - Surgery of the adrenal gland

The adrenal glands sit on top of both kidneys in the body. They are responsible for producing many hormones which we need to live. They are most known for producing adrenaline and enable us to have the “fight or flight” response during times of stress or danger.

There are diseases which throw the balance of these hormones off which then causes other problems in the body. Pheochromocytoma and aldosteronoma are examples. Pheochromocytoma is a rare, benign tumor that oversecretes adrenaline intermittently. Patients with this problem typically have high blood pressure which seems to come and go, a sudden increase in the number of headaches and excessive sweating and flushing. It is a rare cause of high blood pressure. Patients are typically diagnosed when a tumor is seen in the adrenal gland on special x-rays taken of the abdomen called CT scan. The next step involves the use of special blood tests to check for the adrenaline levels. Once the diagnosis is made, the patient is placed on a special medication to block the effects of the adrenaline as it can be life-threatening in the operating room while the tumor is removed. Once it is safe to proceed, the operation is done laparoscopically with small incisions. The largest incision depends on the size of the tumor, and is typically 2 inches. The conventional operation for this involved a very large 10 – 12 inch incision that was made diagonally across the side of the abdomen. With the laparoscopic approach, patients experience much less pain and are often able to leave the hospital within 2 days.

The aldosteronoma is a different tumor which oversecretes the hormone that tells our kidneys to hold onto sodium (salt) and therefore, water. This also causes high blood pressure, but it is a more constant high blood pressure. It is also difficult to control with medications and patients can often be on 3 or more medications with little control. It is also diagnosed by CT scan and blood tests. Once the diagnosis is made, the tumor is removed just as mentioned above for the pheochromocytoma. No special medication is needed prior to surgery for this tumor.

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