What are the reasons that the Best Adrenal Operation for Adrenal Tumors is the Mini-Back-Scope Operation?

Adrenal surgery can be performed eight different ways, but the best operation for almost all patients is the Mini-Posterior Retroperitoneal Scope Adrenalectomy (the Mini-PRSA), also called the "Mini-Back Scope Operation". The specific adrenal surgical technique used will be dictated by the situation at hand. It is crucial that your adrenal surgeon is comfortable with all different techniques of adrenal surgery since a customized, individual approach will give the best possible outcome. Adrenal surgery should be tailor-made for you and your specific tumor.

What are the Benefits for the Mini-Back Scope Operation: The Mini-Posterior Retroperitoneal Scope Adrenal operation (the Mini-PRSA)?

The Mini-Posterior Retroperitoneal Scope Adrenalectomy (Mini-PRSA) is the preferred technique in >95 % of adrenal surgery cases for a number of reasons:
  • The Mini-PRSA adrenal operation is the safest. There is less mobilization (i.e. dissection of surrounding structures). This leads to less risk of injury to surrounding structures such as the kidney, liver, spleen, pancreas, bowel, or major vessels such as the inferior vena cava; IVC. You want the safest possible operation. Dr. Carling has never had an injury to surrounding structures or other organs during an adrenal operation--which is fairly common for surgeons who don't do adrenal surgery several times per week.
  • This Mini-PRSA adrenal operation is much faster than any other techniques. There is no value in a fast operation, per se. The operation needs to take as long as is required to get the job done. However, a fast operation means that your surgeons is experienced and knows what he/she is doing. It is not uncommon that an adrenalectomy that would take 2-4 hours at the most prestigious hospitals (yes, we are talking about the top 20 hospitals in the US News & World Report), can be performed by Dr. Carling in 20-30 minutes. Again, there is no value in a fast operation, per se. However, a faster operation means less time under general anesthesia. Although, general anesthesia is very safe, the longer time the patient is under general anesthesia, the greater risk of anesthesia-related complications such as nausea, vomiting, blood clots, pulmonary embolism, neurocognitive symptoms and in some cases long-term effects on cognition and memory.
  • The surgeon does not need to enter the intra-abdominal cavity when performing the Mini-PRSA (Mini-Back-Scope Operation). This means that even for patients with previous operations on the abdomen, the surgeon does not need to deal with adhesions (scar tissue). Intra-abdominal scars (known as adhesions) may be from previous operations such as bariatric surgery (gastric band, sleeve gastrectomy, gastric bypass), gallbladder surgery (cholecystectomy), liver surgery, stomach surgery, bowel surgery of any kind (colectomy, appendectomy, etc) or any previous kind of gynecological operations (Caesarian section, hysterectomy, etc). Also, this means you are not at risk of developing future intra-abdominal scars. (known as adhesions) which can lead to problems with small bowel obstruction (SBO).
  • There is less postoperative pain following the Mini-Back-Scope Adrenal operation (the Mini PRSA). Many patients only take Tylenol (acetaminophen) after the operation. Very few patients need strong pain-killers.
  • The patients typically go home much faster. The typical patient would spend less <23 hours in the hospital, whereas patients having an operation through the front of the abdomen typically stay 2 or 3 days.
  • The recovery is faster following the Mini Back Scope Adrenal operation. Most people return to work within a few days. You can start your hobbies, and exercises a lot faster following a Mini-PRSA, whether you engage in walking, running, biking, gym exercises, yoga, weight lifting, skiing, tennis, golf or any other work-outs.
  • The cosmetic outcome is exceptional and superior to any other technique.
  • There almost always no blood loss following the Mini-Back Scope Adrenal operation. Yes, it is true. Watch Dr. Carling’s surgical videos and you can see that there is no blood loss. There is less blood loss when Dr. Carling performs a Mini-back scope adrenalectomy (Mini-PRSA) compared to when you have your annual blood tests by your primary doctor where they draw a few tubes of blood. Dr. Carling has never, ever in his entire career had to order a blood transfusion during or after an adrenal operation.
  • For patients requiring bilateral adrenalectomy, there is no moving, flipping and turning the patient around during the Mini-Back Scope Adrenal operation. This is better for the patients and the entire operating room staff.
There is no question, that the Mini Posterior Retroperitoneal Scope Adrenalectomy (Mini-PRSA)--also called the Mini-Back-Scope Adrenal operation is the best for about 95% of all patients that require adrenal surgery. If your surgeon is not planning to do the operation this way, then you may want to consult with a different surgeon. Adrenal surgery is almost NEVER an emergency. The tumor that needs to be removed has typically be present for at least 4-5 years, so therefore you have time to seek the expert opinion of a surgeon like Dr Carling that does adrenal surgery all the time.