University of Virginia Health System

At the University of Virginia the Endocrine Surgical Group has had extensive experience with adrenal surgery. In some patients there might be involvement of both adrenal glands. Additionally other patients may present with abdominal disease highly suggestive of malignancy. Such patients are explored through an abdominal approach (laparotomy). For those patients that have a functioning tumor or an enlarged non-functioning tumor on one side, we have approached these through a flank incision. This necessitates the removal of the 11th or 12th rib. Most patients can expect a 3-4 day hospitalization and 2-3 week recovery time.

Over the last 2 to 3 years, we have been utilizing a laparoscopic approach to the adrenal gland with excellent success. Since 1998, we have performed approximately 40 of these at the University of Virginia with no serious complications and without mortality. We have also approached both functioning and non-functioning tumors through the laparoscopic technique. While the laparoscopic approach has apparent advantages of minimal postoperative pain and more rapid recovery, we agree that there appears to be no obvious financial advantage to the laparoscopic approach as compared to a unilateral flank approach. This is an area where we individualize our surgical approach to offer each patient the optimal care as a result of the most appropriate technique for adrenalectomy.