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Laparoscopic Adrenalectomy: Revisiting Surgical Challenges

Ajay Bhandarwar, MS, FMAS, FIAGES, FAIS, FICS, FBMS, FLCS, Eham Arora, MS, Amol Wagh, MS, FMAS, FIAGES, FAIS, FICS, FBMS, Saurabh Gandhi, MS, FMAS, FALS, Chintan Patel, MS, FMAS, FBMS, Shubham Gupta, MS, Jasmine Agarwal, Gagandeep Talwar. Grant Government Medical College & Sir JJ Group of Hospitals, India

Laparoscopic Adrenalectomy has fast become the standard of care for adrenal lesions measuring up to 15 cm in size. 

There is significant anatomical asymmetry between the two glands with regards to their vascularity & relation to adjacent organs. That right adrenalectomy is easier than the left, is a surgical saying which has been carried forward from the era of open adrenalectomies. 

However, in our series of 52 laparoscopic surgeries, the mean operative time was lower for right sided lesions than left, & we converted a single case of left adrenal adenoma to an open approach. Right adrenalectomies are traditionally considered challenging due to narrow space due to overlying liver & its proximity to the inferior vena cava. However, we have found that these difficulties are largely overcome by a laparoscopic approach.

The use of vascular identification technologies such as IndoCyanine Green Fluorescence has a promising role to play in this surgery. In our experience, with sound surgical skills & the use of a spectrum of energy sources, there is no perceived increased difficulty in laparoscopic right adrenalectomy when compared to the left.  


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86984

Program Number: V284

Presentation Session: Friday Video Loop (Non CME)

Presentation Type: VideoLoop

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