In this operation the adrenal gland is removed through 3-4 small cuts on the flank. Recovery from this operation is still usually rapid, but there is often greater postoperative discomfort for a day or two compared to retroperitoneoscopic adrenalectomy. This is because the gas that has to be inserted into the abdominal (or peritoneal) cavity in order to perform this operation usually gives more postoperative pain than the wounds themselves.
The picture below shows typical scars after this procedure.
Mr Hardy performs this operation for adrenal masses that are too large to be removed by a retroperitoneoscopic approach. This usually means masses larger than 5cm.
Adrenal masses larger than 10cm, or those that are malignant (cancerous) should be removed using an ‘open’ approach by a larger scar across the abdomen.