It was vetted professionally by Master. Doctor Nguyen Tan Cuong – Head of Urology Department. Department of General Surgery – Vinmec Central Park International Adrenal General Hospital.
In addition, adrenal tumors can disrupt the production of certain hormones (hormones) in the body, leading to a range of serious health issues. Surgery is the curative treatment in many cases of benign and malignant adrenal tumors. Robot-assisted surgery is a promising new approach to improving treatment efficiency and patient safety.
1. What Is An Adrenal Tumor?
A gland that is located above each kidney is the adrenal gland. Inflammation, injury, and stress cause adrenal glands to secrete hormones that help the body heal, balance electrolytes, regulate blood pressure, control immune system activity, and repair cell tissues.
Adrenal adenomas are rare tumors that develop in the adrenal glands and are usually benign, with only a very rare occurrence being malignant (cancerous). The Adrenal neoplasms usually occur in only one of the adrenal glands, but in some cases, both.
Adrenal Tumors Can Present In A Variety Of Ways:
- No symptoms: The patient was discovered by chance during a general physical examination, ultrasound, or computed tomography (CT Scan) that an adrenal tumor was found.
- The tumor has an endocrine function, manifested by the syndromes:
- Adrenal myeloma is caused by a catecholamine-secreting tumor, causing a hypertensive crisis.
- Cushing’s syndrome is caused by an increase in cortisol secretion. The patient has symptoms of hypertension, edema, Cushing face, stretch marks…
- Hyperaldosteronism is caused by increased secretion of aldosterone, which reduces blood potassium, leading to muscle weakness and increased blood pressure.
- The tumor causes increased secretion of sex hormones.
The typical symptom of adrenal myeloma is sudden, sudden episodes of paroxysmal hypertension. The patient’s blood pressure is very high, can reach 250-280/120-140 mmHg, lasts from a few minutes to a few hours, then decreases to normal. During a hypertensive crisis, the patient has symptoms such as tachycardia, palpitations, chest pain, headache, nausea, vomiting, frequent urination, pale skin, sweating, and a cold body. Patient worries, panic, fear of death; The patient is usually fatigued after a hypertensive crisis, the blood pressure is normal or may fall, the body has lost a lot of water, and there may be electrolyte imbalances or heart failure. In addition to physical exertion, stress, changes in the body, surgery, and anesthesia can trigger blood pressure episodes.
In some cases, the patient may have frequent hypertension, with occasional episodes of paroxysmal hypertension. Prolonged high blood pressure will lead to many dangerous complications such as myocardial infarction, coronary heart disease, heart failure, cerebrovascular accident, kidney failure, and eye damage that can lead to blindness.
2. How Are Adrenal Tumors Treated?
If the adrenal adenoma is small (< 5cm) and has no endocrine function (no overproduction of adrenal hormones), the tumor is asymptomatic, discovered incidentally during diagnostic tests. imaging may not require treatment. With endocrine and imaging tests to evaluate the tumor size and. Endocrine function of the adrenal gland.
No matter what size the adrenal tumor is or if it is causing hormone overproduction, the patient will need surgical treatment. The treatment for adrenal gland tumors with endocrine function or large tumors > 5cm is surgery to remove the tumor.
Laparoscopic adrenalectomy is a difficult technique. Before surgery, the doctor may prescribe some drugs to use for 7-10 days to help stabilize blood pressure, these drugs can replace or supplement the blood pressure medication the patient is using. The remaining adrenal gland will take care of endocrine functions, produce hormones, and blood pressure will return to normal.
There are two main surgical methods for adrenal gland tumors today: open surgery and laparoscopic surgery. Laparoscopic adrenalectomy is favorable for tumors that are <5cm in size and are benign. Open surgery in cases where there are contraindications to laparoscopic surgery or the tumor is too large, and heavily attached to surrounding organs.
3. Surgical Method With Robot Support In The Treatment Of Adrenal Tumors
Robotic-assisted surgery is a remarkable development of surgery, a promising new approach, and a development trend in the surgical industry. Robotic-assisted surgery has many advantages over classic open and laparoscopic surgery.
With sophisticated, modern structure, perfect simulation of human hand operation, wide surgical angle up to 540 degrees that no human arm can perform, three-dimensional magnified image capable of diagnosis and perform precise, minimally invasive surgery. As such, robot-assisted surgery offers high treatment efficiency and safety, reduces pain and complications for the patient, ensures aesthetics, aids in reducing hospital stay, and quick recovery.
4. Where Is The Effective Treatment For Adrenal Tumors?
The Vine Central Park General Hospital (HCMC) has begun using robotic surgery for digestive and urological procedures in September 2019. and gynecology.
This method has many advantages compared to both classic laparoscopic surgery and robotic surgery with:
- Instruments with surgical heads act as flexibly as wrist joints to help access narrow angles. Increase dissection and cause less damage to adjacent areas compared with classical laparoscopic surgery.
- Automated endoscopes through voice, laser, eye tracking, etc., help doctors actively control and have better vision and control. And increase accuracy and safety in performing surgery art.
- With the advantage of compactness. Robotic arm surgery is less invasive and has many advantages such as small incisions. Less pain, and low risk of infection, thereby helping customers to reduce. Blood loss during surgery as well as to recover faster.
- It is much more affordable than robotic surgery.
Experienced endoscopic doctors and directly received by Master. Doctor Nguyen Tan Cuing – Head of Urology Unit. Department of General Surgery – Vine International General Hospital Central Park performed the surgery.
Master. Doctor Nguyen Tan Cuing has nearly 20 years of experience working in the field of Urology – Men. Especially in laparoscopic surgery for urinary tract diseases, minimally invasive surgery for urinary stones, and cancer. urology and male genitalia. Male infertility… Dr. Cuing has many articles published in domestic and foreign medical journals. And is a member of the Vietnam Association of Urology. Nephrology, and Association American Urology. World Association of Urology Endoscopy.