Robot-assisted adrenalectomy uses the Da Vinci surgical system to enable the surgeon to operate by controlling a series of robotic arms through small incisions in order to remove the adrenal gland, a small gland above each kidney.
Robot-assisted procedures enable dramatically faster recovery than traditional open surgery. Certain patient and tumor characteristics may prevent a robot-assisted approach.
When to Ask a Urologist about Robot-Assisted Adrenalectomy
You should speak with a Urologist about Robot-Assisted Adrenalectomy if you have an adrenal tumor that is concerning for cancer or actively secreting excessive hormones.
Typically covered by most insurances (although coinsurance and deductibles may apply). Coverage will be verified prior to proceeding. If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.
Outcomes vary depending on the type of underlying tumor if cancer is present. Surgical removal provides cure for hormone-producing tumors.
Possible Side Effects
The risks associated with adrenalectomy include bleeding (with the possible need for transfusion), infection, failure to remove all of the cancer, damage to adjacent structures, adrenal insufficiency requiring steroid replacement, the chance that the adrenal tumor could be benign, hernia, stroke, heart attack, blood clot, and a small (<1%) possibility of death.
Surgical removal is the gold standard management strategy of adrenal lesions concerning for cancer or for producing excessive hormones. Alternatives include observation without treatment.
What to do to Prepare for Surgery
You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery (when to stop depends on the type of blood thinner). Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.
On the day before surgery, you will receive a phone call alerting you to the time that you should arrive, and you should wash the surgical area with an antibacterial soap. You may be instructed to drink one bottle of magnesium citrate to evacuate the bowels in preparation for the procedure.
You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.
What to Expect after Surgery
The surgery typically requires hospitalization for about two nights. Patients have a catheter draining their bladder that is removed prior to discharge. There may be an additional external surgical drain also removed prior to discharge. Light activity, including walking, under nursing supervision is recommended. The nursing staff will also provide teaching to use a breathing device called an incentive spirometer that helps encourage patients to take deep breaths. Patients may begin drinking liquids following surgery and can slowly advance to more solid food as tolerated. It is common to have abdominal discomfort and bloating.