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Bengaluru: Medicover Hospitals, Hoodi, Bengaluru, has successfully treated a 33-year-old woman with a large right adrenal tumour measuring 7.4 × 5.5 cm through robotic-assisted surgery. The patient underwent a robotic right adrenalectomy, performed by Dr. Pramod S, Senior Consultant Urologist and Robotic Surgeon, and recovered satisfactorily following the procedure.
The tumour was found incidentally while her evaluation for some other health problem and was detected of right adrenal mass in routine abdominal ultrasonography. Subsequent imaging revealed a 7.4 × 5.5 cm solid lesion in the right suprarenal region . An incidental hepatic hemangioma in the right lobe was also noted.
Before surgery, the patient underwent a detailed clinical and hormonal evaluation. There were no clinical features suggestive of Cushing’s syndrome, adrenal insufficiency or pheochromocytoma, and she did not have hypertension or hypokalaemia. The pre-operative hormonal work-up was unremarkable.So we suspected adrenal tumour due to size
Considering the size and characteristics of the adrenal mass, the patient was planned for surgical removal.
Normally for open adrenalectomy we have to give incision of around 10 to 20 cm and laparoscopic approaches to adrenal tumour is challenging and chances open conversation is more
So since she is a lady and yet pregnant we opted for robotic surgery , so incision will be minimal and less chances of open conversion.
Robotic right adrenalectomy was performed under general anaesthesia. During the procedure, four robotic ports were inserted, following which the right adrenal gland was carefully identified and meticulously dissected. The adrenal vein and pedicle were ligated, and the adrenal gland was successfully removed. A drain was placed in the operative bed, and the specimen was sent for histopathological examination.
The procedure was completed successfully with negligible blood loss. Following surgery, the patient was shifted to the ICU for close monitoring and remained haemodynamically stable with adequate oxygenation on room air. She experienced mild postoperative pain and nausea, which were managed conservatively with appropriate medication. The postoperative course was otherwise uneventful, and she continued to recover satisfactorily.
Expert Perspective:
Dr. Pramod S said that Adrenal masses incidence is rare are often detected incidentally during imaging performed for unrelated reasons. Once an adrenal mass is identified, a comprehensive evaluation is essential to determine its size, radiological characteristics and whether it is hormonally active. In this patient, the mass was relatively large, measuring 7.4 × 5.5 cm, and after appropriate evaluation, robotic adrenalectomy was performed successfully. Robotic surgery provides enhanced precision and allows meticulous dissection in the anatomically complex adrenal region.”
Post operative the biopsy came as adrenal myelolipoma
What is an Adrenal Myelolipoma?
An adrenal myelolipoma is an adrenal mass that was identified in this patient on imaging. In this case, the lesion was located in the right adrenal gland and measured 7.4 × 5.5 cm. The patient was asymptomatic, and the mass was detected incidentally during abdominal imaging.
The case highlights the importance of appropriate evaluation of incidentally detected adrenal masses, particularly when they are large or have features requiring further assessment.
The patient was discharged after an uncomplicated postoperative recovery and was advised follow-up.
Adrenal tumour is a rare tumour and in such large adrenal tumour surgical approach must be planned .we opted for robotic surgery as it was as large adrenal tumour and it needs experience and expertise in doing robotic adrenal surgery for such large adrenal tumours
About Medicover Hospitals:
Medicover Hospitals is committed to providing advanced, technology-enabled healthcare with multidisciplinary expertise and patient-centric care. The hospital offers specialised services across multiple medical disciplines, supported by modern diagnostic and surgical facilities.