a technique for complete right adrenalectomy deborah cottrell dvm

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