Adrenalectomy

What is Adrenalectomy

Adrenalectomy is a surgery to remove an adrenal gland. Adrenal glands are organs that make certain hormones that your body needs to function. You have two adrenal glands, one above each kidney. You may need this surgery if an adrenal gland is making too much hormone or if you have a tumor on your adrenal gland.

There are two kinds of adrenalectomy:

• Laparoscopic. This kind is done through small surgical cuts (incisions) with the help of a lighted, pencil-sized instrument (laparoscope).
• Open. This kind is done through a larger incision.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Injury to other organs.
• High blood pressure (hypertension).

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• Do notuse tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider. Quitting will improve your body’s ability to heal after surgery.
• Your health care provider may do blood tests. These tests will check to make sure that your blood can clot normally.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotics to help prevent infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins. You will receive fluids and medicines through this tube during the procedure.
• You may be given a medicine to help you relax (sedative).
• You will be given a medicine to make you fall asleep (general anesthetic).
• A thin, flexible tube (catheter) may be put into your bladder to drain urine.
• A tube may be passed through your nose or mouth and into your stomach (NG tube,or nasogastric tube). This tube removes digestive juices to keep you from feeling nauseous and vomiting.
• If you are having laparoscopic adrenalectomy:
  • Your surgeon will make 2–4 small incisions in your abdomen.
  • Air will be pumped into your abdomen to help your so that your surgeon will be able to see the area clearly.
  • A laparoscope and other small surgical instruments will be put through the incisions.
• If you are having an open adrenalectomy, your surgeon will make a large incision under your rib cage, in the middle of your abdomen, or along your side.
• The blood vessels that lead to the adrenal gland(s) will be tied off or clipped to prevent bleeding.
• The adrenal gland(s) will be removed.
• Nearby organs will be checked.
• Your abdomen will be rinsed with a solution.
• Your muscles will be stitched (sutured) back together.
• The incision(s) will be sutured or stapled.
• A bandage (dressing) will be used to cover the incision(s).
• If a tube was inserted into your bladder or stomach, it will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given pain medicines as needed.
• You may be started on some new medicines. For example, if you had this procedure because an adrenal tumor was making too much of a hormone called cortisol, you may need to take prednisone or cortisol pills after surgery.
• If you had a tube down your throat, your throat may feel sore.
• Do notdrive for 24 hours if you received a sedative.

Adrenalectomy, Care After

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

If you had a tube down your throat, your throat may feel sore.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do notdrive for 24 hours if you received a sedative.
• Do notdrive or operate heavy machinery while taking prescription pain medicine or medicine for nausea.

Activity

• Do notlift anything that is heavier than 10 lb (4.5 kg).
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Incision care

• Follow instructions from your health care provider about how to take care of your surgical cuts (incisions). Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures) or staples in place. They may need to stay in place for 2 weeks or longer.
• Check your incision area(s) every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Follow the diet that your health care provider prescribed for you.
• Weigh yourself and take your blood pressure every day if told by your health care provider. Your health care provider will tell you what results should be reported right away.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around an incision.
• You have more fluid or blood coming from an incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from an incision or a dressing.
• You have a fever or chills.
• Your pain does not improve with the pain medicines you have been given.
• You cannot take your medicines for any reason.
• You feel nauseous or you vomit.
• You are constipated or you have diarrhea.
• You develop a rash.
• You develop a new cough.
• You have problems with your urine, such as:
  • Pain or burning with urination.
  • A need to urinate more often than usual.
  • Blood in your urine.

Get help right away if:

• You have chest pain.
• You have shortness of breath.
• You suddenly feel too weak or dizzy to stand or walk.
• You have a severe increase in pain.
• You have pain, tenderness, or redness in your calf.
• Your incision or incisions open up. The dressing on an incision may become soaked with blood.