Risks related to laparoscopic / retroperitoneoscopic adrenalectomy.

Any surgical intervention carries a risk. The informed consent process is expected to start with a discussion of all options for treatment, including non-surgical or even ‘no action’. Previously Bolam test suggested that one should provide the information that a similar clinician would be expected to provide in a similar scenario. More recently, the Montgomery principle imposes a duty to inform the patient of any serious (or life-changing) complication, irrespective of how unlikely it is or how small the risk of it is. In this new context, patients’ views and beliefs have to be considered before a final decision to proceed with an operation is made.

It is above the purpose of this website to go into in-depth discussion of such issues as these would differ from patient to patient. The information provided here is made with the assumption that a reasonably fit patient is about to undergo minimally invasive adrenalectomy for Conn’s syndrome. Whether or not you are likely to benefit form the operation and whether you are fit for such an operation will be discussed during your initial clinic appointment.

Laparoscopic adrenalectomy

  • bleeding

  • ileus (slow return of bowel function)

  • bowel injury (from the insertion of the ports)

  • incisional hernia at port sites

Retroperitoneal adrenalectomy

  • numbness on the flank

  • muscle weakness (bulge of the lateral/posterior abdominal wall)

  • as there is no contact with the abdominal content, all other complications related to laparoscopic surgery should not be encountered.

Generic risks associated with keyhole surgery

  • wound infection

  • deep vein thrombosis (i.e. a clot in the veins in the legs) - you will have compression stockings and during the operation we will use flowtron pumps that squeeze your calf muscles to encourage blood flow from the legs back into circulation)

  • risks related to anaesthesia (minimal in a fit patient)

How common each of these complications (and maybe others specific to your condition) are expected to be will be discussed at the first clinic appointment but overall they are exceedingly rare.

In a paper reporting 38 patients operated in our unit before 2012, half of the patients were discharged within 24 hours after their operation. More recently it has become expected that 1-night admission should be sufficient for all patients (see copy of the paper).