The procedure of removal of an adrenal gland is called an adrenalectomy. There are two adrenal glands in the body, both the right and left adrenal glands are located just above and to the right of the kidney. One or both adrenal glands may be removed by surgery depending on the nature of disease.
Prior to surgery, you will need to have a pre-surgical evaluation to be sure you are healthy enough to undergo surgery. You will have blood work done and depending on your age and/or medical history may need other testing, such as an EKG or chest x-ray. If you have a history of significant cardiac or pulmonary conditions, you may need to get clearance from your medical specialist to continue with surgery.
Pre-operative imaging in the case of adrenal masses is critical in planning the surgical procedure. Pre-operative CT or MRI will provide critical information to the location of the mass, involvement of surrounding structures, mass size, and possibility of metastatic disease in the case of adrenal carcinoma. This imaging may also help to differentiate between a concerning mass and a simple benign tumor.
Most patients will be eating, drinking, and walking around the night of their surgery. Patients that have had an open adrenalectomy may need to wait until the next day or two days to eat and drink.
Patients that have a laparoscopic adrenalectomy will have mild pain after surgery that can usually be controlled by non-narcotic pain medications. Patients that have an open adrenalectomy may require pain control with narcotics.
A light bandage consisting of a gauze pad and a clear plastic covering will be placed over your incision after surgery. This bandage may be removed 48 hours after surgery. If you have steri-strips on your incision, leave them in place until they begin to fall off naturally. If they have not fallen off in 7-10 days, you may gently remove them.
If staples were used to close your incision, leave them in place, they will be removed on your follow up clinic visit. Your incision may be sensitive so avoid tight restrictive clothing. You may feel a firm ridge directly under the incision. This is normal and will soften and go away when healing is complete usually in 3-6 months.
All incisions are sensitive to sunlight. The ultraviolet light of the sun and tanning booths will darken the scar area in the first year. Always use sunscreen.
You may shower the day after surgery. Try not to get the bandage totally soaked. Once the bandage is off, it is still OK to shower. Still, try not to totally saturate the incision. You should not go swimming or soak in a tub or hot tub until your surgeon tells you it is okay.
You may eat whatever you choose. You may prefer softer foods and liquids initially if you have a sore throat. Advance your diet as you see fit. Make sure you stay hydrated. Your appetite may be decreased right after surgery, but will improve with time.
Take NSAIDS like ibuprofen, naproxen or acetaminophen for the first 3-5 days as needed. Take medication as directed by the surgeon.
The adrenal glands are two small organs, one located above each kidney. They are triangular in shape and about the size of a thumb. The adrenal glands are known as endocrine glands because they produce hormones. These hormones are involved in control of blood pressure, chemical levels in the blood, water use in the body, glucose usage, and the “fight or flight” reaction during times of stress. These adrenal-produced hormones include cortisol, aldosterone, the adrenaline hormones – epinephrine and norepinephrine – and a small fraction of the body’s sex hormones.
Diseases of the adrenal gland are relatively rare. The most common reason that a patient may need to have the adrenal gland removed is excess hormone production by a tumor located within the adrenal. Most of these tumors are small and not cancers. They are known as benign growths that can usually be removed with laparoscopic techniques. Removal of the adrenal gland may also be required for certain tumors even if they aren’t producing excess hormones, such as very large tumors or if there is a suspicion that the tumor could be a cancer, or sometimes referred to as malignant. Fortunately, malignant adrenal tumors are rare. An adrenal mass or tumor is sometimes found by chance when a patient gets an X-ray study to evaluate another problem.
In the past, making a large 6 to 12 inch incision in the abdomen, flank, or back was necessary for removal of an adrenal gland tumor. Today, with the technique known as minimally invasive surgery, removal of the adrenal gland (also known as “laparoscopic adrenalectomy”) can be performed through three or four 1/4-1/2 inch incisions. Patients may leave the hospital in one or two days and return to work more quickly than patients recovering from open surgery. Results of surgery may vary depending on the type of procedure and the patients overall condition.
Common advantages are:
As with any operation, there is a risk of a complication. Complications during the operation may include:
Be sure to call your physician or surgeon if you develop any of the following:
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