Robotic adrenalectomy

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Who is suitable for robotic-assisted adrenalectomy?

What are the advantages of robotic-assisted adrenalectomy?.

How is a robotic-assisted adrenalectomy performed?

What to expect after a robotic-assisted adrenalectomy?

Procedure outcomes

INTRODUCTION

Robotic-assisted adrenalectomy is a minimally invasive surgical approach to remove a diseased adrenal gland. A healthy adrenal gland produces hormones that are essential for normal bodily function. Benign (non-cancerous) tumours can develop in the adrenal gland which may produce abnormally high levels of hormones, resulting in harmful effects on the body. In rare cases, a cancerous tumour may develop. Using state-of-the-art robotic equipment and a keyhole approach, the surgeon removes the adrenal gland without disrupting the normal adjacent kidney.

Doctors Shekib Shahbaz and Tony de Sousa of Melbourne Urology Centre are fully trained and experienced in the use of the da Vinci System, which is the specialized robotic-assisted surgical device that is used in this procedure.

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Who is suitable for robotic-assisted adrenalectomy?

Robotic-assisted adrenalectomy may be an option for patients with:

  • A benign adrenal tumour which is producing abnormal levels of hormones
  • A cancerous adrenal tumour

What are the advantages of robotic-assisted adrenalectomy?.

Robotic-assisted adrenalectomy offers both the surgeon and the patient various benefits when compared to conventional laparoscopic or open surgery. The entire operation can be performed with a minimally invasive approach without the need to make a large incision.

The potential benefits of robotic surgery include:

  • Smaller incisions
  • Less blood loss
  • A shorter hospital stay and faster recovery time
  • Greatly enhanced, high definition 3D vision inside the body
  • Small and precise instruments that allow a greater range of movements than the human hand

How is a robotic-assisted adrenalectomy performed?

  • The patient is placed under general anaesthetic for the duration of the procedure, which lasts around 3 hours
  • Between 3-5 small keyhole incisions are made in the abdomen, through which the surgical instruments and camera are inserted
  • Carbon dioxide is used to inflate the patient’s abdomen, creating space required for the surgeon to view and access the affected adrenal gland
  • The affected adrenal gland is located and carefully dissected free from the kidney and other surrounding structures
  • Special care is taken to avoid damaging the kidney or major blood vessels nearby
    The adrenal gland is removed though a small incision
  • Carbon dioxide is released and the robotic instruments are removed
  • Incisions are sealed carefully, to reduce the chance of hernia or scarring

What to expect after a robotic-assisted adrenalectomy?

  • You will remain in hospital for 2-3 nights following your procedure
  • A specialist medical physician or endocrinologist may be involved in your care
  • There will be some mild pain or discomfort which can be managed with medication
  • You will be encouraged to sit out of bed and walk around, as well as perform deep-breathing exercises to minimize the chance of pneumonia or blood clots in the legs or lungs (DVT/PE)
  • Uncommon complications include:

    • Damage to major blood vessels or other organs during surgery
    • Incisional hernia (usually where there are problems with wound healing)

Procedure outcomes

Most patients are able to return to their normal activities within 2-3 weeks following a robotic-assisted adrenalectomy. Strenuous activities and heavy lifting should be avoided for 6 weeks following surgery to minimize the chance of bleeding or hernia.
The body can function completely normally with a single adrenal gland after one is removed.

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