60650 Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal

Name of the Procedure:

Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal.

Summary

Laparoscopy with adrenalectomy is a minimally invasive surgical procedure to remove part or all of the adrenal gland or to explore the gland and possibly take a biopsy. The surgery can be performed through various approaches including the abdomen, lower back, or dorsal area.

Purpose

This procedure addresses conditions affecting the adrenal gland such as tumors, hyperplasia, or other growths. The goal is to remove abnormal tissue, diagnose conditions, and alleviate symptoms such as hormonal imbalances or pain.

Indications

• Adrenal tumors (benign or malignant)
• Adrenal hyperplasia
• Cushing's syndrome
• Pheochromocytoma
• Unexplained adrenal masses detected via imaging studies

Preparation

• Fasting for 8 hours prior to the procedure
• Adjustment or cessation of certain medications as advised by a doctor
• Blood tests, imaging studies, and sometimes hormonal studies to assess adrenal function

Procedure Description

1. Anesthesia: The patient is given general anesthesia for the procedure.
2. Incision and Access: Small incisions are made in the abdomen, lower back, or dorsal area to insert a laparoscope (a tiny camera) and surgical instruments.
3. Exploration and Biopsy: The surgeon explores the adrenal gland and may take a biopsy if needed.
4. Adrenalectomy: If necessary, part or all of the adrenal gland is removed.
5. Closure: The incisions are closed with sutures or staples.

Duration

The procedure typically takes 1-3 hours, depending on the complexity.

Setting

Performed in a hospital or surgical center with facilities for laparoscopic surgery.

Personnel

• Surgeon specialized in laparoscopic surgery
• Surgical nurses
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Common: Infection, bleeding, and pain at the incision site
• Rare: Injury to surrounding organs, blood clots, and complications from anesthesia

Benefits

• Minimally invasive with smaller incisions
• Quicker recovery time compared to open surgery
• Accurate diagnostic and therapeutic outcomes
• Relief from symptoms caused by adrenal gland disorders

Recovery

• Patients typically stay in the hospital for 1-2 days post-surgery
• Full recovery can take 2-4 weeks
• Instructions include wound care, pain management, and activity restrictions
• Follow-up appointments to monitor recovery and adrenal function

Alternatives

• Open adrenalectomy: Involves a larger incision and longer recovery time
• Medical management: For less severe conditions without immediate need for surgery
• Monitoring: For smaller, non-symptomatic adrenal masses

Patient Experience

Patients may experience mild to moderate pain post-surgery, managed with pain medication. Discomfort at incision sites and fatigue are common, but gradually improve over a few weeks. Most patients can return to normal activities within a month.