adrenal glands

The adrenal glands (also known as adrenal glands ) are two endocrine glands (right and left) located in the depth of the abdomen, protected by the spine, ribs, kidney and abdominal viscera.

Its primary function is to secrete a wide variety of hormones , hormones needed to regulate body temperature, blood pressure, character, sleep-wake, appetite, emotions and even sex. The importance of these glands resides in that small hormonal alterations often produce serious disorders and diseases. A deficit or hormonal excess greatly affects the health and quality of life of patients.

Diseases of the adrenal glands

The adrenal can be sick. There is a type of pathology that does not produce detectable hormonal alteration and therefore it can be difficult to diagnose , these would be non-producing tumors (adenoma, myelolipoma ...). Usually this disease does not give any recognizable or specific symptoms, although patients may present abdominal pain and discomfort or symptoms due to compression of another viscus. They are usually diagnosed incidentally (they are occasionally found when looking for another disease).

Another type of pathology is that which produces hormonal alteration (defect or excess), such as adenoma, pheochromocytoma, Cushing's syndrome, etc.. The diagnosis is made through the examination of the symptoms recognizable by this excess or defect of the specific hormone.

Although some of these dysfunctions have medical treatment, in certain occasions it is necessary to operate to remove the adrenal gland. This is the case of some benign non-functioning tumors of more than 4 cm, all functioning benign tumors (Sd. Conn, pheochromocytoma) and adrenal carcinoma.

Metastases of other tumors that settle in the gland discovered during the follow-up of the neoplastic disease are also frequent.

Adrenal cancer is rare but very aggressive. There are different types of presentation, but the most frequent is hypersecretory carcinoma. It usually sits on masses of more than 6 cm and the hormonal secretion is mixed. Before your suspicion should be operated early, if you can ensure complete exeresis of the tumor.

Mini-invasive transperitoneal (anterior) and retroperitoneal (posterior) laparoscopic approach

The intervention to remove the adrenal glands can be done through two approaches : Transperitoneal or Retroperitoneal. We can offer either of the two ways if the patient needs it.

Transperitoneal laparoscopy (through the abdomen): we perform the intervention using minimally invasive techniques , both standard laparoscopy, mini-instruments and single-port surgery (SILS) for an impeccable aesthetic result, to perform these approaches we use efficient sealing devices (ligasure) and last generation endoscopic support.

In our setting we find a series of patients in whom the performance of a standard laparoscopy can be difficult , problematic or even contraindicated due to its characteristics (obesity), due to its antecedents (abdominal operations, stomata, abdominal visceral cancer, liver cirrhosis). ...), in these cases the transperitoneal approach (anterior) can put at risk the integrity of the abdominal viscera. We are able to carry out the intervention from "behind".

Retroperitoneal laparoscopy (posterior approach): we perform the intervention using minimally invasive techniques, both standard laparoscopy and single-port surgery (SILS), from the retroperitoneal space, avoiding contact and manipulation of the abdominal viscera. Despite being a more complex technique that requires more technical training, it offers obvious advantages for most patients, such as shorter hospital stay, less postoperative pain and lower risk of abdominal complications.