Adrenalectomy -- Open Surgery
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- Insufficient cortisol production
- Decreases in blood pressure
- Infections in the wound, urinary tract, or lungs
- Blood clots in the legs
- Injury to nearby organs or structures
- Adverse reaction to anesthesia
- Increased age
- Long-standing cortisol excess
- Poor nutrition
- Recent or chronic illness
- Heart or lung problems
- Use of certain medicines such as blood pressure pills, muscle relaxants, tranquilizers, sleeping pills, insulin, steroids, sedatives, or hypnotic agents
- Use of illegal drugs such as LSD, hallucinogens, marijuana, or cocaine
What to Expect
Prior to Procedure
- Physical exam
- Blood tests
- Urine tests
- Imaging tests, such as abdominal ultrasound , abdominal CT scan , MRICT scan of the head , and nuclear scan
- Give certain medicines to determine why the adrenal gland is not working correctly
- Aspirin or other anti-inflammatory drugs
- Blood-thinning medications
- Anti-platelet medication
- Arrange for a ride to and from the procedure.
- Arrange for help at home after the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be given laxatives and/or an enema. These will clean out your intestines.
Description of the Procedure
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- You will likely require pain medicines.
- You may be nauseated for a few hours after surgery. Your doctor may place a nasogastric tube through your nose and into your stomach. It will drain fluids and stomach acid. You will not be able to eat or drink until this is removed and you are no longer nauseated. In this case, you will continue to receive IV fluids. When you begin eating, you may need to eat a lighter, blander diet than usual.
- You may be given special compression stockings to decrease the possibility of blood clots forming in your legs.
- Your body may be making substantially less natural steroid hormones. Your doctor may start you on steroid medicines immediately after surgery. The dose will be gradually reduced.
- You will need to be carefully monitored to see that your body is producing the right amount of steroids and hormones. Monitoring also verifies that you are taking the correct dose of steroid or homone replacement medicine.
- You may be asked to weigh yourself daily and report any weight gain of two or more pounds over 24 hours. Such weight gain may indicate that you are retaining fluid. You may be asked to monitor your blood pressure regularly at home.
- Try to increase your physical activity according to your doctor's instructions. This will help you avoid respiratory complications from the general anesthesia and improve the recovery of your digestive system.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Be sure to follow your doctor’s instructions .
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medications you have been given
- Pain, burning, urgency, or frequency of urination; blood in the urine
- Cough, shortness of breath, or chest pain
- Pain and/or swelling in your feet, calves, or legs
- Any new symptom
Urology Care Foundation http://www.urologyhealth.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
Canadian Urological Association http://www.cua.org
The Kidney Foundation of Canada: British Columbia Branch http://www.kidney.bc.ca
Agha A, von Breitenbuch P, Gahli N, et al. Retroperitonenscopic adrenalectomy: lateral versus dorsal approach. J Surg Oncol . 2008;97:90-3.
Gallagher SF, Wahi M, Haines KL, et al. Trends in adrenalectomy rates, indications, and physician volume: A statewide analysis of 1816 adreanlectomies. Surgery . 2007;142:1011-21.
Hanssen WE, Kuhry E, Casseres YA. Safety and efficacy of endoscopic retroperitoneal adrenalectomy. Br J Surg . 2006;93:715-9.
Jossart GH, Burpee SE, Gagner M. Surgery of the adrenal glands. Endocrinol Metab Clin North Am . 2000;29:57-68.
Munver R, Del Pizzo JJ, Sosa RE. Adrenal-preserving minimally invasive surgery: the role of laparoscopic partial adrenalectomy, cryosurgery, and radiofrequency ablation of the adrenal gland. Curr Urol Rep . 2003;4:87-92.
Pamaby CN. The role of laparoscopic adrenalectomy for adrenal tumours of 6 cm or greater. Surg Endosc . 2008;22:617-21.
Thompson SK, Hayman AV, Ludlam WH, et al. Improved quality of life after bilateral laparoscopic adrenalectomy for Cushing’s disease: a 10-year experience. Ann Surg . 2007;245:790-94.
- Reviewer: Lawrence Frisch, MD, MPH; Michael Woods, MD
- Review Date: 05/2013 -
- Update Date: 03/18/2013 -