University:
Swansea University
Course:
PM-139 | Human Physiology 1
Academic year:

2023
Views:

206

Pages:

4
Author:

Amal J.

ADRE NALECTOMYDef:surgical removal of the suprarenal (adrenal) gland in calledA drenalecto myIndication :HypertorticismTumours of the adrenal medullaGanglio neuromaphew chro mocytomaNeuro blas homaDisseminated carcinoma ofbreast and perostate not respondingradiotherapyAdreno cortical hormonereplacement therapy It is essential that allpatients who are to be subjectedto adrenalectomy are supported intraand POS to operatively by adrenocortical hormone replacement therapyirrespective to entent ot thoudrenalresoctionoperationIncisionpostero lateral incision throughloin, or trans verse \ Anterior(or)oplique abdominal thoracoupperabdominal incision such as usedin nephrectomy .Posterior approach. - posterolateral incision through join aftersubperiostal resection otizthriblower border ot the pleava isdefined and protectedIncision is extended throug hthebed of the 12th rib to reveal theperinephric with in which thefatadrenal gland is identified, on the right side the suprarenal veen is short and may beterm from the vena cava if itis not identi fied & ligaled atan early stage of thedissection By tinger and gauzedissection keeping close to thegland the gland is freed frombelow and behind upwardsatigating and dividing bleedingvessels are they are encountereduntill it is suspended by itmain vascular pedicle near itsopenDiaphragmatictasciasepteemRenal fasciaAn terior approach - through acurved transverge incision orlong midnline - incision. The left gland is approached1st by entering along the lateralleaf of the lionorenal ligamentand then curving down wards &medially so as to enable aside peri toneal flap to bereflected by retracting thespleen downwards & medialthe adrenal gland comes intoview the fascia over its lateralborder is incised and bygo gua 2 dissection the bloodvessels of the gland aredefined ligated & dividedthus treezing the gland whichis removed After removal eachgland should be inspected tocheck its completeness & eachadrenal bed must be searchedfor the presence of accessoryadrenal tissue (present -in 32%of cases ) "If this imp ortant stepis omitted failure of theoperation is no + unlikelis