We have come a long way in the technical performance of adrenalectomy in the 100 year history of adrenal surgery.
The first successful resection of a pheochromocytoma was performed by Charles Mayo in 1926, and the first with a correct pre-operative (clinical) diagnosis was two years later by Arthur Shipley of Baltimore. It would be another decade before a biochemical diagnosis was available, and another 55 years before CT scanning became available in for diagnostic use.
The last twenty years have seen significant advances in surgical techniques for pheochromocytoma. Minimally invasive techniques have been introduced and refined, resulting in lower risk and faster recovery for patients. More recently, the posterior retroperitoneal approach to adrenalectomy (PRA) has improved surgical technique further, with improved visualization facilitating advanced techniques such as partial adrenalectomy for select patients with bilateral disease. Given the improved access and reduced tissue manipulation in posterior retroperitoneoscopic adrenalectomy (PRA,) the idea of abandoning pre-operative alpha blockade is being actively investigated, and may represent the future of pheochromocytoma surgery.