Open Adrenal Surgery
This is the traditional way of performing adrenal surgery. It involves making a large skin incision under the right or left rib cage or the midline of the abdomen.
Right Open Adrenalectomy
The right lobe of the liver is freed to expose the right adrenal gland. The vessels to and from the adrenal gland are divided and the gland is freed from the right kidney.
Left Open Adrenalectomy
The pancreas and spleen are freed to expose the left adrenal gland. The vessels to and from the adrenal gland are divided and the gland is freed from the left kidney.
Open adrenal surgery is performed less today as laparoscopic adrenalectomy has become the accepted operation for most adrenal disorders. Open adrenal surgery is recommended or may be necessary in certain instances, including:
- Cancer of the adrenal gland
- Large adrenal tumor greater than 10-cm
- Tumors with features suggestive of cancer
- Hypersecretion of multiple hormones
- Regional lymph nodes
- Metastasis (spread)
- Clinical feminization
- Contraindication to laparoscopic surgery
- Prior abdominal operations (liver, spleen or kidney surgery)
Disadvantage of Open Adrenal Surgery
Open adrenal surgery is associated with more pain, longer hospital stays and a higher rate of overall complications, including bleeding, wound infections and abscess formation.
For this reason, most adrenal operations performed today are done using the laparoscopic technique.