Adrenalectomy (Adrenal Gland Surgery)
What are the Adrenal Glands?
The adrenal glands are small and are located above each kidney. The adrenal glands are our endocrine glands that produce hormones. Even though they are small, about the size of your thumb, the hormones produced are important in controlling blood pressure, our water balance, our chemical balance, glucose, and your “fight or flight”reaction. The hormones produced include cortisol, aldosterone, the adrenaline hormones, epinephrine and norepinephrine. The adrenal gland also produces your body’s sex hormones.
Adrenal Gland Symptoms
Adrenal gland problems usually occur when a mass or tumor forms on the gland. Most masses are benign and not cancerous.
Patients with adrenal gland problems may have a variety of symptoms related to excess hormone production.
Pheochromocytomas produce excess hormones that can cause very high blood pressure, headaches, excessive sweating, anxiety, palpitations, and rapid heart rate off and on.
Aldosterone producing tumors cause high blood pressure and low potassium levels. This sometimes causes weakness, fatigue, and frequent urination.
Cushing’s syndrome is too much cortisol. Usual symptoms are: obesity, high blood sugar, high blood pressure, menstrual irregularities,and fragile skin. Most cases of Cushing’s syndrome, are caused by small pituitary tumors. Adrenal glands only cause Cushing’s in about 20% on patients.
Adrenal Gland Surgery
Your surgeon may be trained and able to perform your adrenal gland surgery with minimally invasive laparoscopic surgery. Unlike open surgery which requires a larger incision, laparoscopic adrenal gland surgery requires only three or four 1/4 to 1/2 inch incisions. Your surgeon inserts a tiny TV camera into your body so he can see to perform your surgery. The advantages:
Reduced postoperative pain
Shorter hospital stay
Quicker return to activity
Reduced risk of infection
Some surgeons may choose to use the traditional open surgery method, perhaps due to your health and condition. This decision may be made before or even during your surgery if conditions warrant.
Adrenal gland surgery is conducted as follows:
The surgery is performed under a complete general anesthesia, so that the patient is asleep during the procedure and feels no pain.
For laparoscopic surgery, a laparoscope is connected to a special TV camera. This gives the surgeon a magnified view of the adrenal gland.
It is almost always necessary to remove the entire adrenal gland in order to safely remove the tumor.
After the surgeon removes the adrenal gland, the small incisions are closed.
Adrenalectomy (Adrenal Gland Surgery)
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Preparing for Adrenal Gland Surgery
Prior to surgery, your surgeon will review with the risks and benefits of the operation.
Your doctor will tell you which of your normal medications, including over the counter medications, you may continue to take take.
Before your surgery after midnight, you should not eat or drink anything except any medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
Prior to surgery, some patients may need medications to control the symptoms of the tumor, such as high blood pressure.
Patients with a pheochromocytoma will need to be started on special medications several days prior to surgery to control their blood pressure and heart rate.
Patients with an aldosterone problems may need to have potassium checked and take extra potassium if the level is low.
Patients with Cushing’s syndrome will need to receive extra doses of cortisone medication on the day of surgery and for a few months afterwards until the remaining adrenal gland has resumed normal function.
Blood transfusion may be necessary during the surgery.
If you smoke it’s helpful to quit.
Hospital discharge planning staff and your doctor will decide if you will need help when you return home.
After Adrenal Gland Surgery
Many people feel better in just a few days.
After laparoscopic adrenal gland removal, most patients can be cared for on a regular surgical nursing unit. Most patients can be discharged from the hospital within one or two days after surgery.
If your blood pressure needs to be watched, you may stay in the intensive care unit.
Patients with an aldosterone-producing tumor may need to continue to take medications to control their blood pressure.
Patients with cortisol-producing tumors and Cushing’s syndrome will need to take prednisone or cortisol pills after surgery.
Patients can remove any dressings and shower the day after the operation.
Patients are encouraged to engage in light activity while at home after surgery.
After surgery pain is usually mild , but may require a pain pill or pain medication.
Most patients can resume normal activities within one week.
A follow up visit will be made with your surgeon in 2 weeks.