Adrenalectomy

Adrenalectomy is a surgery to remove the adrenal gland. One adrenal gland is located on top of each kidney. The adrenal glands produce chemicals (hormones) that your body needs to function. An adrenal gland may need to be removed if it is producing too many hormones or if it develops a growth or tumor.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with numbing medicines.

  • History of bleeding problems or blood clots.

  • Blood pressure problems.

  • Family history of thyroid problems.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • Infection.

  • Bleeding.

  • Injury to other organs.

  • Problems with your body's salt levels.

  • Changes in your body's hormone levels.

BEFORE THE PROCEDURE

  • Stop smoking if you smoke. Doing so will improve your health after surgery and improve your healing from surgery.

  • Blood tests may be performed to make sure your blood clots normally. You may need to stop taking blood thinners (anticoagulants) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin.

  • Do not eat or drink anything at least 8 hours before surgery.

  • Talk to your caregiver about taking your regular medicines (such as high blood pressure medicine) on the morning of your surgery.

  • Ask your caregiver for instructions if you take insulin or medicine to lower your blood sugar.

PROCEDURE

  • An intravenous (IV) access tube is put into one of your veins to give you fluids and medicines.

  • You will receive medicines to relax you and medicines that make you sleep (general anesthetic).

  • You may have a flexible tube (catheter) put into your bladder to drain urine.

  • You may have a tube put through your nose or mouth into your stomach (nasogastric tube). The nasogastric tube removes digestive juices and prevents you from feeling sick to your stomach (nauseous) and throwing up (vomiting).

If you are having laparoscopic adrenalectomy:

  • Two to four small cuts (incisions) will be made in your abdomen.

  • Air will be pumped into your abdomen to allow your surgeon to view the area clearly.

  • A small camera with a light and small surgical instruments are put through the incisions.

  • Images will be projected onto a monitor, allowing your surgeon to see the inside of your abdomen.

If you are having an open adrenalectomy:

  • Your surgeon will make a larger incision under your rib cage (either in the front or in the back), in the middle of your abdomen, or along your flank.

During either procedure:

  • Your blood vessels leading to the adrenal gland will be tied off or clipped to prevent bleeding. Then, the adrenal gland can be removed either through the large open incision or through one of the small laparoscopic incisions.

  • Other nearby organs will be inspected.

  • Your surgeon will use warm saline to rinse the abdominal cavity.

  • The muscles will be stitched (sutured) back together again and the overlying skin will be sutured or stapled.

  • A germ-free (sterile) bandage (dressing) may be used to cover the incision(s).

AFTER THE PROCEDURE

  • You will wake up in a recovery room, resting in bed until you are fully awake. You will have access to pain medicines.

  • Your temperature, breathing rate, heart rate, blood pressure, and oxygen level (vital signs) will be monitored regularly.

  • Your throat may feel slightly sore if you had a tube down your throat.

  • You may be admitted to a regular surgical unit in the hospital for 1 or 2 days. However, you may be required to briefly stay in the intensive care unit (ICU) to monitor your blood pressure more closely. You will usually be kept in the hospital until you can:

  • Eat and drink without nausea or vomiting.

  • Urinate and have bowel movements.

  • Walk around in a reasonably comfortable fashion.

  • You may be started on some new medicines.