ENDOCRINE

Adrenal Gland Removal or Laparoscopic Adrenalectomy

The adrenal glands are two small organs, one located above each kidney. The adrenal glands are known as endocrine glands because they produce hormones. The most common reason that a patient may need to have the adrenal gland removed is excess hormone production by a tumor located within the adrenal gland. Most of these tumors are small and not cancerous. They are known as benign growths that can usually be removed with laparoscopic techniques.

In the past, making a large 6- to 12-inch incision in the abdomen, flank or back was necessary for removal of an adrenal gland tumor. Today, with minimally invasive surgical techniques, removal of the adrenal gland (also known as laparoscopic adrenalectomy) can be performed through three or four quarter-inch to half-inch incisions.

What to Expect

The surgery is performed under a complete general anesthesia. A laparoscope (a tiny telescope) connected to a special camera is inserted into the abdomen. This gives the surgeon a magnified view of the patient’s internal organs on a TV screen. Other instruments are inserted which allow your surgeon to delicately separate the adrenal gland from its attachments. The adrenal gland is then placed in a small bag and removed through one of the incisions. It is almost always necessary to remove the entire adrenal gland in order to safely remove the tumor.

What are the advantages of a Laparoscopic Adrenalectomy?

  • Improved cosmetic result
  • Less postoperative pain
  • Quicker return to normal activity
  • Reduced risk of herniation or wound separation
  • Shorter hospital stay

Spleen Removal or Laparoscopic Splenectomy

The spleen is a blood filled organ located in the upper left abdominal cavity. It is a storage organ for red blood cells and contains many specialized white blood cells that filter blood.

There are several reasons why a spleen might need to be removed. The most common reason is a condition called ITP, or idiopathic thrombocytopenia purpura (low platelets of unknown cause). Hemolytic anemia (a condition that breaks down red blood cells) and hereditary conditions that affect the shape of red blood cells may also require a splenectomy. Additionally, if the spleen gets enlarged, it sometimes removes too many platelets from your blood and has to be removed.

What to Expect

For a laparoscopic splenectomy, patients will be placed under general anesthesia. A laparoscope (a tiny telescope connected to a video camera) is put into the abdomen. Several instruments are placed in different locations on the patient’s abdomen to allow your surgeon to remove the spleen. After the spleen is cut from all that it is connected to, it is placed inside a special bag. The bag with the spleen inside is pulled up into one of the incisions on the abdomen. The spleen is then broken up into small pieces (morcellated) within the special bag and completely removed.

What Are the Advantages of a Laparoscopic Splenectomy?

  • Better cosmetic results
  • Faster return to a regular, solid food diet
  • Less postoperative pain
  • Quicker return to normal activities
  • Shorter hospital stay

Excerpted from Society of American Gastrointestinal Endoscopic Surgeons’ Task Force on Patient Information.