Alan Dackiw, M.D., Ph.D., M.B.A. Answers Questions On: Minimally Invasive Adrenal Surgery

In the past, most adrenal operations required relatively large midline or subcostal incisions or open incisions. But now, when we are not suspicious that the patient has an adrenal cortical cancer or primary adrenal tumor, most often we use laparoscopic or robotic methods in a minimally invasive fashion with small incisions, which results in more rapid recovery for patients.

Yes. For functional tumors or functional nodules on the adrenal gland or for tumors like pheochromocytomas or aldosteronomas or for Cushing’s syndrome where there’s over-activity of a mass or nodule in the adrenal gland, the first-line treatment in most cases is laparoscopic removal of the adrenal gland on the side that the mass is producing too much hormone.

Most of the time, they’re in the hospital for just one or two nights after laparoscopic or minimally invasive adrenal surgery. It’s a rapid recovery in terms of eating, mobility, and return to normal function or return to work. And pain is much less than with open surgery, so patients can go home on just oral pain medicine.

The medical preparation for this kind of surgery can be significant in terms of preoperative preparation. Certain medications may be needed ahead of time, so we work closely with a medical endocrinologist to prepare patients so it’s medically safe to perform the operation they need.