Laparoscopic surgery for adrenal tumors

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Most people with adrenal tumors are between the ages of 20 and 50 and the disease is usually benign. Adrenectomy is surgery to remove one or both of the adrenal glands, to remove the tumor and return the patient to a normal life.

1. What is an adrenal tumor?

The adrenal gland is an endocrine gland located above each kidney. The adrenal gland plays an important role, helping to secrete hormones that regulate the body's vital activities.
Adrenal adenoma is a rare medical condition, the majority of which are benign. Usually, the tumor appears on one side of the adrenal gland, but sometimes the tumor appears on both sides.

2. Symptoms of adrenal gland tumor

Because the tumor secretes a lot of catecholamines, the typical symptom of the disease is a sudden episode of hypertensive crisis or a prolonged state of high blood pressure, with occasional episodes of paroxysmal hypertension.
During a hypertensive crisis, the patient's blood pressure rises very high, lasts a few minutes or a few hours and then decreases on its own without treatment. The patient's heart rate is fast, feeling of severe headache, chest pain, sweating, pale skin, nausea, vomiting, panic, fear of death. During and after the hypertensive crisis, the patient urinated profusely.
After the hypertensive crisis, the blood pressure returns to normal, the patient is tired, there may be electrolyte disturbances, heart failure due to dehydration. If high blood pressure occurs for a long time, there will be many dangerous cardiovascular complications such as cerebrovascular accident, myocardial infarction, coronary artery disease, kidney and eye damage,...

Most adrenal adenomas are benign, but in rare cases, adrenal tumors are malignant (cancerous) tumors that can metastasize from either an adrenal tumor or a parathyroid tumor. lymph nodes to other parts of the body such as the lymphatic system, liver, lungs, and skeletal system.

3. Laparoscopic surgery for adrenal tumors

Laparoscopic surgery to remove the adrenal tumor is the best treatment for patients with adrenal tumors. When the tumor is removed, the patient's blood pressure and weight will return to normal, the complications of high blood pressure are eliminated.
Laparoscopic surgery for adrenal tumors has many advantages over open surgery such as less bleeding, faster wound healing, less pain, and faster recovery. Thanks to modern facilities, the surgical field is clearly visible, so laparoscopic surgery can access the adrenal gland easily. Many studies have evaluated that laparoscopic surgery is the gold standard in the treatment of adrenal tumors.
Laparoscopic surgery takes place as follows:
Prepare the patient: before surgery, the patient is anesthetized, has an arterial blood pressure line, inserted a nasogastric tube, placed a urethral catheter and cleaned the intestines. Surgical process: Transperitoneal surgery, the patient lies at a 90-degree angle on the operating table, the doctor will make an incision on the skin of the rib cage with a length of 1.5cm and insert the laparoscope. Then, following the guidance of the bronchoscope through the first trocar, place the remaining 2 trocars in the mid- and anterior inferior axillary lines. Conduct dissection and cut the fat layers around the kidney, determine the boundary between the upper pole of the kidney and the adrenal gland, and then locate the adrenal tumor. Dissect the tumor and bring the tumor out through the incision connecting the trocar hole of the posterior axillary line and the middle axillary line, stopping the bleeding of the vessel peduncles. Post-operative care: Patients are monitored arterial blood pressure, body temperature, breathing rate and drainage every 15-30 minutes. When blood pressure is stable, transfer the patient to the treatment room, monitor blood pressure in the first day every 1 hour. Give adequate fluids, use antibiotics to prevent infection, relieve pain with non-steroid drugs or morphine.

4. Where is the best place to operate adrenal gland tumor?

Laparoscopic surgery for adrenal tumors is a difficult technique, because the tumor is located posteriorly in the peritoneum, located between the liver, kidney and large blood vessels, the danger is how the blood vessels of the adrenal gland pour directly into the adrenal gland. vena cava. Therefore, if there is a mistake during the implementation, the hormone of the adrenal gland will be released into the blood and sent straight to the heart, the patient's blood pressure will increase suddenly, the risk of brain blood vessel rupture immediately. Therefore, the performing doctor must be very meticulous, careful, professional, experienced and skilled.
At Vinmec International General Hospital, patients will be examined and treated with a team of leading medical experts, a team of highly specialized and experienced surgeons. The system of equipment is invested in modern machinery, the most advanced sterile operating room, high-tech imaging techniques such as CT scan, MRI, PET, targeted therapy at General Hospital. Vinmec International helps to detect and screen tumors with high accuracy; Ensure the surgery is carried out safely and with the highest efficiency.

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