No more dependency on steroid supplements – Laparoscopic Cortical-Sparing Adrenalectomy Surgery

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Meenakshi Mission Hospital and Research Centre (MMHRC) recently treated a 33-year-old woman from Sivagangai for "bilateral pheochromocytoma," a rare case of tumours in both adrenal glands, with a novel laparoscopic procedure known as "cortical-sparing adrenalectomy" - a first for Tamil Nadu. The young patient no longer needs to rely on medicine because the surgery spared the cortex, the portion of the gland that produces the vital hormone cortisol. The human body has two adrenal glands, responsible for producing hormones like cortisol, aldosterone, and adrenaline. 

Pheochromocytoma, a rare tumour, develops in these glands. Bilateral pheochromocytoma is very rare, with only 10% of patients having bilateral tumours. The treatment for pheochromocytoma is surgical removal. In this patient with bilateral pheochromocytoma, both adrenal glands were removed, resulting in lifelong medication. However, surgeons at Meenakshi Mission Hospital used a 'cortical-sparing adrenalectomy' technique to remove the right side adrenal gland while sparing the cortex of the left side, preventing hormonal deficiency.

The surgical team, including Dr. Ramesh Ardhanari, Dr. N. Mohan, and Dr. N. Maharajan, performed a 2-hour surgery requiring precision and exceptional skills. The patient's blood cortisol levels remained normal after a month, indicating normal functioning of the left adrenal cortex, and no complications occurred during or after the surgery. The patient at MMHRC underwent a rare surgery to remove a bilateral adrenal tumour. The tumour, which was 10 cm in size on the right side and 2 cm in size on the left side, caused high blood pressure. 

The patient was treated with antihypertensive medications and stabilized her blood pressure. The right side adrenal gland was removed, but the left adrenal gland was spared. The surgery was performed laparoscopically, minimizing postoperative pain and expediting recovery compared to traditional open surgery. This minimally-invasive approach facilitated a swift recovery post-surgery, enhancing the patient's quality of life. The successful outcome highlights the importance of advanced surgical techniques and multidisciplinary collaboration in managing complex medical conditions.

Dr. S. Jegadesh Chandra Bose, Senior Consultant for Bariatric and Metabolic Surgery, attended a press conference to discuss a patient's sister who had bilateral adrenal tumors and underwent bilateral open adrenalectomy, resulting in lifelong medication dependency.


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