Safety of Laparoscopic Adrenalectomy in Patients with Large Pheochromocytomas: A Single Institution Review

Excerpt

In 1926, separated by a few months and several thousand miles, surgeons César Roux at the University of Lausanne (Switzerland) and Charles Mayo of the Mayo Clinic (USA) successfully resected, without a preoperative diagnosis or any patient preparation, the first pheochromocytomas [1, 2]. Nearly 70 years later, Michel Gagner and colleagues skillfully removed adrenal tumors laparoscopically, issuing in a revolution of surgical innovation in the name of patient safety and comfort [3]. Over the past eight decades, surgeons, endocrinologists, and anesthesiologists have struggled to navigate each and every patient’s course through preparation and extirpation of pheochromocytomas. Although surgical resection of pheochromocytomas can be dangerous, current modifications of preoperative α- and β-blockade, preoperative hydration and salt supplementation, intraoperative addition of rapid-acting pharmaceutical agents, and improved surgical technique have led to numerous reports of low morbidity following adrenal surgery for catecholamine excess [4‐7]. …