About The Condition
Your adrenal glands sit on top of your kidneys and produce multiple hormones. Surgery for adrenal conditions is directed at removing an adrenal gland that contains either a tumor that is producing too much hormone or a tumor that is or has the potential to be a cancer. Specific conditions include:
- Pheochromocytoma. This is an adrenal nodule that produces abnormal levels of norepinephrine and dopamine, often causing palpitations, hypertension and headaches that may be episodic.
- Conn’s syndrome. Conn’s syndrome refers to an adrenal nodule that produces aldosterone. Patients with elevated aldosterone levels often have hypertension that is difficult to control with medications and may be taking multiple blood pressure medications at the time of diagnosis.
- Cushing syndrome. An adrenal nodule that produces excess cortisol results in weight gain, skin changes, muscle weakness, bone density loss and a variety of other symptoms.
- Non-functional tumors or incidentalomas. Tumors found incidentally on imaging studies that do not correspond to increased endocrine function are called non-functional tumors or incidentalomas. Based on their size, imaging criteria or risk of being a cancer, your physician may want to remove them in order to obtain a definitive diagnosis.
- Cancers. The adrenal glands may develop an adrenal cancer within a gland or be the site of metastasis for a cancer from another organ. Surgical removal of an adrenal gland may be necessary to treat the cancer.
Before Surgery
Prior to your surgery, your surgeon will evaluate imaging and lab studies, often in consultation with an endocrinologist, a doctor who specializes in hormones, to determine the nature of your adrenal nodule. You may need a panel of specific blood and urine tests to determine if your adrenal glands are producing abnormal levels of hormones. You also may be asked to:
- Stop smoking prior to your surgery. Nicotine decreases blood flow, prevents healing after surgery and increases your risk of infection.
- Increase your activity. Aim for 30 minutes of walking or other aerobic activity daily to build strength.
- Improve your nutrition. Add protein supplements such as Boost or Ensure to help your body heal after surgery.
- Take a specific regimen of medications prior to surgery to prevent fluctuations in hormone function during your operation, if you have a specific type of tumor.
Please ask your physician about any additional steps you should take before your surgery.
Surgery
Our surgeons perform open surgery, as well as minimally invasive surgeries, for adrenal abnormalities. The decision to perform a specific type of operation is often dictated by the anatomic and size characteristics of your particular tumor, as well as your past history of operations and health. Your surgeon will explain your particular procedure in more detail at your consultation.
Minimally invasive surgery. Minimally invasive surgery is performed with laparoscopy or robot-assisted surgery using the da Vinci Surgical System.
- Laparoscopic surgery. Laparoscopic surgery requires only a few small incisions into which your surgeon will fit long, thin surgical instruments and a tiny camera. The camera will provide images to guide the surgeon during the procedure.
- Robotic surgery. Some laparoscopic surgeries may be performed using the da Vinci Surgical System. This robotic option gives your surgeon a magnified 3D high-definition view inside your body. The system also enables the surgeon’s hand movements to be translated into precise movements of small instruments inside your body.
Open surgery. Minimally With open surgery, your physician will make an incision at the site of the abnormality large enough so he or she can see and touch your internal organs while operating.
After Surgery
- You will be encouraged to walk to prevent blood clots, muscle weakness and constipation.
- You may not be hungry at first, so return to a normal diet slowly. Check with your physician about using supplements if your appetite is poor.
- You may experience constipation. If so, you may take a laxative such as Miralax or Milk of Magnesia.
- Ice may help to reduce the swelling for the first 48 to 96 hours. Then use heat to ease muscle soreness and relax tight muscles.
- You may use ibuprofen in addition to prescription pain medication to help with pain control.
- A small amount of bleeding or drainage is expected from the wound during the first one or two days.
- You may shower one or two days after surgery, but avoid baths, hot tubs, soaking or swimming for at least two weeks.
- Always talk to your surgeon about weight restrictions and return-to-work options.
- You will be asked to see your surgeon in one to three weeks after surgery.
- If you notice a fever greater than 101 degrees Fahrenheit or drainage from your wound, let your surgeon know by calling 763.780.6699.
If you have additional questions, please contact us at 763.780.6699.
