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Laparoscopic Left Adrenalectomy (Tumor)

Laparoscopic left adrenalectomy is the gold standard surgery for benign adrenal tumors <6 cm with lateral transabdominal approach.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Laparoscopic Left Adrenalectomy (Tumor)?

Laparoscopic left adrenalectomy is the standard treatment for benign adrenal tumors <6 cm. Established by Gagner (1992); has overtaken open surgery worldwide. The most preferred approach: lateral transabdominal (Gagner). Other options: posterior retroperitoneoscopic (Walz), anterior transabdominal.

Indications: functional tumors — aldosteronoma (Conn syndrome), pheochromocytoma, Cushing adenoma, virilizing/feminizing tumors. Non-functional: incidentaloma >4 cm, growing or radiologically suspicious mass. Contraindications: tumor >10 cm, infiltrative malignancy (open surgery preferred).

Pre-op preparation: pheochromocytoma → α-blockade (phenoxybenzamine 10-14 days) + β-blockade + IV hydration. Aldosteronoma → spironolactone 4-6 weeks + K+ replacement. Cushing → glucocorticoid replacement (post-op). Surgical steps: 4 ports → spleen-pancreas medialization → renal vein and adrenal vein control → lateral and inferior dissection → en-bloc removal. Operative time 90-120 minutes.

Symptoms

Aldosteronoma: hypertension + hypokalemia
Pheochromocytoma: paroxysmal hypertension, palpitations, sweating
Cushing: central obesity, moon face, buffalo hump
Virilizing: hirsutism, acne, virilization (in women)
Incidentaloma: usually asymptomatic
Pain due to mass effect (large tumors)

Risk Factors

MEN2A/MEN2B (medullary thyroid + pheochromocytoma)
Von Hippel-Lindau syndrome
Neurofibromatosis type 1
Familial paraganglioma syndromes
Resistant hypertension (Conn screening)
Female gender (Cushing more common)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Resistant hypertension + hypokalemia
  • Paroxysmal hypertension + palpitations
  • Cushing syndrome symptoms
  • Incidentaloma >4 cm or growing
  • Hirsutism + virilization (in women)
  • MEN2 family screening

Treatment Methods

01
Pre-op functional study (cortisol, metanephrine, aldosterone/renin)
02
Pheochromocytoma: α-blockade 10-14 days
03
Aldosteronoma: spironolactone 4-6 weeks
04
Laparoscopic lateral transabdominal approach
05
4-port technique + en-bloc removal
06
Postop hormone replacement (Cushing)

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.