Date post: | 29-Mar-2015 |
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A Technique for Complete Right Adrenalectomy
Deborah Cottrell DVM
www.westendanimal.com
Common Techniques
• Subtotal by intracapsular surgical debulking
• Subtotal by cryotherapy
• Subtotal by CO2 laser
• Bonus question: What does L.A.S.E.R. stand for?
• Vena Cava ligation
Debulking
• Very safe.
Little or no hemorrhage
Short surgery time
• Sometimes only option if tumor is very large
• About 70% grow back within six months
Vena Cava Ligation
• Survival rate surprisingly high—about 80%.
• Not acceptable except in circumstances where there are no other options
• Last resort if vena cava suffers too much damage during surgery
Collateral Circulation
• Many ferrets with large right adrenals have established alternate circulation around liver
• Mostly occurs through vertebral veins
• Caval ligation survival rate directly related to degree of collateral circulation available.
• Can be determined intra-operatively by taking blood pressure after clamping
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Instruments: Satinsky and DeBakey Clamps
Hemostasis