Why the Mini Back Scope Adrenalectomy (MBSA) is the Best Adrenal Operation

What are the reasons that the Best Adrenal Operation for Adrenal Tumors is the Mini Back Scope Adrenalectomy (MBSA)?

Adrenal surgery can be performed eight different ways, but the best operation for almost all patients is the Mini Back Scope Adrenalectomy (MBSA), also called the "Mini Posterior Retroperitoneoscopic Adrenal Operation". The specific adrenal surgical technique used will be dictated by the situation at hand. It is crucial that your adrenal surgeon is comfortable with all different techniques of adrenal surgery since a customized, individual approach will give the best possible outcome. Adrenal surgery should be tailor-made for you and your specific tumor.

What are the Benefits of Mini Back Scope Adrenalectomy (MBSA)?

The Mini-Posterior Retroperitoneal Scope Adrenalectomy (Mini-PRSA) is the preferred technique in >95 % of adrenal surgery cases for a number of reasons:

Dr. Carling inspecting that the positioning of the patient is perfect prior to proceeding with Mini Back Scope Adrenalectomy (MBSA).

• The Mini Back Scope Adrenalectomy (MBSA) operation is the safest. There is less mobilization (i.e. dissection of surrounding structures). This leads to less risk of injury to surrounding structures such as the kidney, liver, spleen, pancreas, bowel or major vessels such as the inferior vena cava (IVC). You want the safest possible operation. Dr. Carling has never had an injury to surrounding structures or other organs during an adrenal operation--which is fairly common for surgeons who don't perform adrenal surgery several times per week.
• The Mini Back Scope Adrenalectomy (MBSA) is much faster than any other technique. There is no value in a fast operation, per se. The operation needs to take as long as is required to get the job done. However, a fast operation means that your surgeon is skilled, experienced and knows what he/she is doing. It is not uncommon for an adrenalectomy that would take 2-4 hours at the most prestigious hospital (yes, we are talking about the top 20 hospitals in the U.S. News & World Report), can be performed by Dr. Carling in 20-30 minutes. Again, there is no value in a fast operation, per se. However, a faster operation means less time under general anesthesia. Although general anesthesia is very safe, the longer time the patient is under anesthesia, the greater risk of anesthesia-related complications such as nausea, vomiting, blood clots, pulmonary embolism, headache, and in some cases longterm effects on cognition and memory.
• The surgeon does not need to enter the intra-abdominal cavity when performing the Mini Back Scope Adrenalectomy (MBSA). This means that even for patients with previous operations on the abdomen, the surgeon does not need to deal with adhesions (scar tissue). Intra-abdominal adhesions may be from previous operations such as bariatric surgery (gastric band, sleeve gastrectomy, gastric bypass), gallbladder surgery (cholecystectomy), liver surgery, stomach surgery, bowel surgery of any kind (colectomy, appendectomy, etc) or any previous kind of gynecological operations (C-section, hysterectomy, etc). Also, this means you are not at risk of developing future intra-abdominal scars, which can lead to problems with small bowel obstruction, a fairly common complication of traditional surgical techniques.
• There is less postoperative pain following the Mini Back Scope Adrenalectomy (MBSA). Many patients only take Tylenol (acetaminophen) after the operation. Very few patients need strong painkillers.

The Mini Back Scope Adrenalectomy (MBSA) is performed with a fiberoptic camera and fine endoscopic instruments.

• Patients typically go home much faster. The average patient would spend <23 hours in the hospital, whereas patients having an operation through the front of the abdomen typically is required to be hospitalized for 2 or 4 days.
• The recovery is faster following the Mini Back Scope Adrenalectomy (MBSA). Most people return to work within a few days. You can start your hobbies, and exercises a lot faster following a Mini Back Scope Adrenalectomy (MBSA), whether you engage in walking, running, biking, yoga, weight lifting, skiing, tennis, golf or any other workouts.
• The cosmetic outcome is exceptional and superior to any other technique.
• There is almost always no blood loss during the Mini Back Scope Adrenalectomy (MBSA). Yes, it is true. Watch Dr. Carling’s surgical videos and you can see that there is no blood loss. There is less blood loss when Dr. Carling performs a Mini Back Scope Adrenalectomy (MBSA) compared to when you have your annual blood tests by your primary doctor where they draw a few tubes of blood. Dr. Carling has never, ever in his entire career had to order a blood transfusion during or after an adrenal operation.
• For patients requiring a bilateral adrenalectomy, there is no moving, flipping and turning the patient around during the Mini Back Scope Adrenalectomy (MBSA). This is better for the patient and the entire operating room staff.

There is no question, that the Mini Back Scope Adrenalectomy (MBSA) is the best for about 95% of all patients requiring adrenal surgery. If your surgeon is not planning to do the operation this way, then you may want to consult with a different surgeon. Adrenal surgery is almost NEVER an emergency. The tumor that needs to be removed has typically been present for at least 4-5 years, so therefore you have time to seek the expert opinion of a surgeon like Dr. Carling who performs adrenal surgery all the time.

What are some of the things you should know about adrenal gland surgery? Read more on our adrenal surgery blog