Adrenal-sparing surgery

Abstract

Partial adrenal resection,also known as adrenal-sparing surgery or subtotal adrenalectomy, is the removal of an adrenal tumor with preservation of the normal surrounding adrenal tissue. The aim of a partial adrenal resection is to safely and completely resect the adrenal mass while leaving intact a functional portion of the gland. Partial adrenalectomy was initially described using the standard, open technique [8, 22], whereas recent reports refer to a laparoscopic approach [7, 9, 10, 16, 25]. Laparoscopy lends itself nicely to partial adrenalectomy because of the high level of magnification that allows for a more detailed inspection of the adrenal gland, aiding in the distinction between the tumor mass and the normal adrenal tissue. The focus of this chapter is on laparoscopic partial adrenal resection, with a description of the indications, preoperative evaluation, operative technique, and postoperative follow-up of patients undergoing this procedure.Despite some reported successes with partial adrenalectomy, it is important for the reader to keep in mind that the current standard of care for patients undergoing surgery for an adrenal mass is complete resection (Fig. 1).