Why have this procedure?
Laparoscopic adrenalectomy (also known as keyhole removal of the adrenal) is an operation that may be suggested to manage either an overactive, enlarged or cancerous adrenal gland. It is a major urological operation that has virtually replaced the traditional alternative of open surgery. The vast majority of patients with adrenal problems requiring surgery, but not all patients are suitable for keyhole surgery, and your surgeon will advise about the best approach to a particular problem. Compared to open surgery keyhole surgery gives the surgeon better vision and is associated with less blood loss during the operation, but can be technically demanding. Other advantages of keyhole surgery are smaller scars (better cosmesis and lower risk of hernias and infection), shorter hospital stay and quicker general recovery time.
Most patients will have seen an Endocrinology Doctor for investigations and treatment with medication before being referred to a surgeon. Alternatives to removing the adrenal, with risks and benefits of treatment will be discussed before planning surgery.
Why choose us?
Our consultants are recognised experts in the field of keyhole kidney and surgery. They help other surgeons to introduce this type of surgery to their hospitals, and are often referred difficult cases from other hospitals. In some respects they are pioneers and have been the first surgeons in the world to report some aspects of keyhole kidney surgery. Because our surgeons encounter the adrenal gland every time they operate on a kidney they are very familiar with it. Mr Anurag Golash works closely with the local Endocrinology Doctors and is the local lead for adrenal surgery.
Coming in for this procedure
Before the operation you will be invited to come to the hospital for a pre-operative assessment (including blood tests and heart trace). On the day of the operation you will be asked to give written consent for the operation. The operation is performed under general anaesthesia and usually takes between 2 and 3 hours. When you wake up pain is usually minimal and often controlled by tablets. Some patients are fit to go home on the day of surgery, but many stay overnight. There are risks and side effects associated with all forms of treatment and these should be carefully considered before surgery. Serious complications associated with major surgery (heart, lung, and thrombosis problems that could lead to death) are very rare. Serious bleeding, damage to the bowel or other internal organs is likewise rare. The commonest problem after this surgery is pain at the wound that the adrenal gland is removed from. The kidney can be damaged during the surgery and if the adrenal gland is very enlarged the kidney may need to be removed to safely remove the adrenal gland.
Follow up after the procedure
If the adrenal is removed for cancer then regular follow-up with periodic scans and blood tests will be required to monitor the course of any remaining cancer. If the adrenal gland is not cancerous then it is unusual to require surgical follow-up, with the exception of one post-operative visit to ensure all is well. However, further follow-up and treatment with the endocrinology team or GP may be necessary.