Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor
CPT4 code
Name of the Procedure:
Adrenalectomy (Partial or Complete); Adrenal Gland Exploration with or without Biopsy, Transabdominal, Lumbar or Dorsal; Excision of Adjacent Retroperitoneal Tumor
Summary
An adrenalectomy is a surgical procedure to remove one or both adrenal glands, which are small glands located above the kidneys. The surgery can be partial (removing only a part of the gland) or complete (removing the entire gland). The procedure can also involve the removal of a nearby retroperitoneal tumor and can be performed using different surgical approaches.
Purpose
The primary purpose of an adrenalectomy is to treat tumors located on or near the adrenal glands, whether they are cancerous or benign. It aims to alleviate symptoms caused by excessive hormone production or by the physical presence of the tumor.
Indications
- Non-cancerous tumors producing excess hormones
- Adrenal cancer
- Pheochromocytoma (tumors causing high blood pressure)
- Metastatic tumors to the adrenal gland
- Unexplained masses in the adrenal gland
Preparation
- Fasting for 8-12 hours before surgery.
- Adjustment or cessation of certain medications as directed by the doctor.
- Blood tests, imaging studies (CT scan, MRI), and hormone level assessments.
Procedure Description
- Anesthesia: Administered general anesthesia.
- Incision: Depending on the approach (transabdominal, lumbar, or dorsal), a suitable incision is made.
- Exposure: The adrenal gland is exposed, either directly or with the help of laparoscopic tools.
- Excision: The adrenal gland (or part of it) and any adjacent retroperitoneal tumor are carefully excised.
- Biopsy: Tissue samples may be taken for further analysis.
- Closure: The wound is closed using sutures or staples.
Duration
The procedure typically takes 2-4 hours.
Setting
Adrenalectomy is generally performed in a hospital surgical suite.
Personnel
- Surgeon (specialized in urology or endocrinology)
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Bleeding and blood clots
- Infection
- Injury to nearby organs
- Hormonal imbalance
- Adverse reactions to anesthesia
Benefits
- Removal of problematic tumors
- Normalization of hormone levels
- Potential cure of adrenal cancer
- Alleviation of symptoms such as high blood pressure
Recovery
- Hospital stay for a few days
- Pain management with prescribed medications
- Gradual return to normal activities within 2-4 weeks
- Follow-up appointments to monitor hormone levels and overall recovery
Alternatives
- Pharmacological treatments to manage hormone levels
- Radiation therapy for certain cancerous tumors
- Minimally invasive procedures for smaller, non-cancerous tumors
Patient Experience
Patients may feel woozy or discomfort immediately after the surgery, controlled with pain medications. Rehabilitation includes walking and light activities to aid recovery. Most patients can expect to regain full function within a few weeks, although some hormonal adjustments may require ongoing management.