ABSTRACT
This chapter focuses on potential complications of laparoscopic adrenalectomy. It addresses specific aspects of preoperative and postoperative management. Laparoscopic adrenal surgery is more complex than procedures such as pelvic lymphadenectomy, renal biopsy or varicocelectomy, and carries a different portfolio of complications. The dynamics of the pneumoperitoneum have the potential for multiple metabolic consequences. Pneumoperitoneum can cause decreased cardiac output, metabolic acidosis, secretion of vasopressin and catecholamines, and decreased urine volume. Patients with Cushing’s syndrome present unique risk factors because of the hypercortisolism brought about by their disease state. They are more prone to infectious and thromboembolic complications as well as respiratory distress and consequent anesthetic complications related to hypercapnia. Additional complications include pleural tear, Addisonian crisis, myocardial infarction, stroke, pneumonia, temporary relaxation of the abdominal wall, and temporary hypesthesia of the abdominal wall, chronic port site pain, multisystem organ failure, and gastrointestinal bleeds.
