September 9, 2010

New approach eases adrenal tumor removal

Featured Image

James Broome, M.D., left, and Carmen Solorzano, M.D., are using a new technique to remove adrenal tumors. (photo by Jen Westrup)

New approach eases adrenal tumor removal

Surgeons at the Vanderbilt Endocrine Surgery Center recently performed an innovative procedure, and Tennessee's first, that is paving the way for easier, less painful removal of adrenal tumors.

By making just three small incisions to the back, James Broome, M.D., and Carmen Solorzano, M.D., were able to remove a benign tumor from a patient using a camera-guided, laparoscopic surgical technique.

Known as retroperitoneoscopic adrenalectomy, the procedure is just gaining acceptance over traditional methods that remove tumors through the abdomen, which can be difficult in patients with extensive scar tissue from previous abdominal surgeries.

By approaching the tumor from the back, surgeons can more easily access the adrenal gland, which lies just above the kidneys, without risk to adjacent abdominal organs.

The procedure also benefits patients, who recover faster and leave the hospital sooner.

The adrenal glands regulate the production of hormones, including those necessary for the human body to deal with stress. But tumors in these glands can disrupt the process, leading to a wide range of vague symptoms, often masking the overall problem.

This was the case in Vanderbilt's first posterior adrenalectomy patient.

The 54-year-old female was in treatment at Vanderbilt for breast cancer, but also suffered from intermittent symptoms, including severe headache, accelerated heart rate and increased blood pressure.

Doctors began to piece together the vague symptoms, and diagnostic imaging ultimately revealed a tumor that was increasing production of adrenaline.

The new procedure was performed on a Friday morning, and the patient was able to go home the next day.

Solorzano, director of the Vanderbilt Endocrine Surgery Center, and Broome this summer returned from Germany, where they trained under the direction of Martin Walz, M.D., professor of surgery at the Kliniken Essen-Mitte Hospital. Walz first reported the technique in 1996.

He is often cited as the father of posterior laparoscopic adrenalectomy, today performing more than 170 such procedures each year.

While there, Solorzano and Broome assisted in the removal of eight adrenal tumors in seven patients. Vanderbilt treats between 40 and 50 patients with adrenal tumors each year.

“Our hope is to become a regional center of expertise where patients can finally find answers to this often elusive disease,” said Solorzano.