Adrenal glands, as the name suggests, are small (3-5 g) triangular prism-shaped organs located on both kidneys (Figure 1). Even though they are small in size, the work they do is gigantic. Because these glands provide many chemical and hormonal balances in the body. Diseases occurring in these glands can cause very serious illnesses. For many years, surgeries on the adrenal glands were performed using open surgical methods. However, with the development of laparoscopic (closed) surgery techniques in the field of medicine, open surgeries began to be replaced by closed surgeries in the field of urology. Although this technique has become the standard in America and European countries today, open surgery is still performed in many centers in our country. These are based on the lack of equipment as well as the low number of experienced urologists trained in this field.
What is laparoscopic adrenal gland surgery?
It is very small (about 1 cm) from several points in the abdomen. ) is the surgery of the adrenal gland by making incisions and using long instruments and a camera system inserted from there. The process of removing the kidney gland due to a mass is called Laparoscopic Adrenalectomy or Laparoscopic Adrenalectomy.
What are the advantages of laparoscopy?
Open surgery of the adrenal gland is much more difficult than kidney surgeries. This is because these glands are located in more difficult places because they are deeper and closer to the main veins. Therefore, in this surgery, larger skin incisions are made and surgery times are longer than in kidney surgery.
One of the biggest advantages of laparoscopy is that very small incisions are made instead of the previous incisions of around 30-40 cm. This not only means a better cosmetic appearance, but also a quicker and smoother recovery. This becomes especially important in patients whose wounds close late or are prone to infection, such as diabetics. In addition, it offers the advantages of patients staying in the hospital for a shorter period of time as they recover faster, returning to their daily life activities more quickly, and being able to start work more quickly. ar. Again, patients have the advantage of feeling less pain and using less medication after surgery. Especially in experienced hands, surgery times are much shorter than open surgeries and the patient receives less anesthesia.
Are all masses seen in the adrenal glands malignant (cancer)?
Most of the masses in the adrenal glands are detected incidentally. In other words, it is detected that there is a mass in this area in films such as Ultrasonography, Tomography or Emar (MRI) taken for patients who go to the doctor for any reason. Sometimes, the presence of some signs that our health is deteriorating raises the suspicion that there will be a mass in the adrenal gland, and this area is examined and diagnosed. Masses seen in the adrenal glands are roughly divided into two as benign or malignant (cancer). Cancer is diagnosed by looking at some values on films such as tomography and MRI.
Benign masses are again divided into two; 1- Harmless masses, 2- Masses that produce excessive hormones. If it is determined that there is a hormone-secreting mass in blood and urine tests, then the treatment is surgery. Whether surgery is required for harmless masses is decided by looking at the size of the mass. In general, masses smaller than 4 cm are called for intermittent check-ups and the patient is monitored. Surgical removal of larger masses is the most appropriate treatment. Because as the size increases, the likelihood of the mass containing tumor cells or causing other problems increases.
In cases where surgery is required, Laparoscopic surgery, which is performed by making 3 or 4 incisions of approximately 0.5-1cm in length, instead of open surgery by cutting almost half of the abdomen, is one of the greatest blessings provided by today's technology.
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