OVERVIEW

The adrenal glands are two organs located in the upper part of each kidney, which produce hormones to regulate various functions of our body, such as blood pressure, carbohydrate levels, among others.

Most tumors that arise in the adrenal glands are not malignant (cancer), but they can form hormones in excess.

The reasons to remove the adrenal glands are:

  • Pheochromocytoma (catecholamine-secreting tumor)
  • Cushing’s syndrome (cortisol-secreting tumor)
  • Conn syndrome (aldosterone-secreting tumor)
  • Non-secreting adenomas that produce pain.
  • Malignant (cancerous) tumors

Surgery to remove the adrenal gland is called an adrenalectomy and can be performed openly or laparoscopically.

Benefits of laparoscopic adrenalectomy

When performed by laparoscopy, adrenalectomy is a surgery that offers rapid recovery and little postoperative pain.

The control of hormone levels by adrenalectomy is very effective in the case of benign tumors that secrete hormones. In the case of the removal of malignant tumors (cancer), the adrenalectomy offers an excellent control of the disease, since the suprarenal gland is eliminated with the tumor and part of the surrounding fat.

Risk and Complications

Most people can live with only one adrenal gland; however, it is sometimes necessary to remove both adrenal glands; in such cases, the administration of medication is necessary to avoid hormonal imbalance; for this purpose, joint management with an endocrinologist is suggested.

In addition to the possible general complications of any surgery (hemorrhage, damage to nearby organs, etc.) during surgery, there may be a lack of control of blood pressure, especially when an adrenalectomy is performed due to a pheochromocytoma, once the adrenal gland has been removed, the blood pressure tends to normalize.

The risk of conversion to open surgery is low (<5%), this may be due to difficulties in the dissection or removal of the tumor and is performed to maintain patient safety.

Alternatives to adrenalectomy

In the case of hormone-secreting tumors, some medications can control the secretion of these hormones. If cancer is suspected, the best option is to completely remove the adrenal gland.

What to expect from laparoscopic adrenalectomy?

Day of surgery:

You will arrive at the hospital the same day of surgery on an empty stomach.

The surgery takes approximately 2 to 3 hours; however, this time is variable.

Anesthesia for this procedure is general, so you will be asleep during surgery.

Pain after laparoscopic adrenalectomy is minimal and can be effectively controlled with intravenous analgesics.

Food: you can eat in the afternoon after the surgery, there are no dietary restrictions, however, a balanced diet is recommended.
Physical activity: you can walk the same day after surgery. It is normal to feel a little tired after any surgery, that problem resolves spontaneously a few weeks after laparoscopic adrenalectomy.

Hospital stay: most patients undergoing laparoscopic adrenalectomy remain hospitalized for 2 to 3 days.

Wounds: Laparoscopic adrenalectomy requires 3 small incisions in the back (each 1 cm or less), once they are completely healed, these scars can rarely be seen.

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