Consumer Information

Laparoscopic Adrenalectomy

WHAT YOU SHOULD KNOW:

Laparoscopic adrenalectomy is surgery to remove the adrenal gland. It is done when a small tumor is found on the gland. . It may also be done if you are bleeding, , or if you have a chronic (long-term) infection, or other growths in the adrenal gland. Surgery may also be done for an adrenal gland disease, such as Addison disease, that is causing severe (very bad) symptoms. The adrenal gland is a small gland that sits on top of each kidney. The glands produce hormones and chemicals that control how different parts of your body work. An adrenal gland disease may cause the glands to make too much or not enough of these substances. This may lead to high blood pressure, hypoglycemia (low blood sugar), Cushing syndrome, or Addison disease.
During a laparoscopic adrenalectomy, small incisions (cuts) are made in your abdomen (stomach). Caregivers will insert special tools and a laparoscope through these incisions to do the surgery. A laparoscope is a long metal tube with a tiny video camera and a light on the end. This gives caregivers a clear view of the abdominal area by looking at a TV monitor. Your caregiver may remove the whole adrenal gland or just part of it. After this surgery, the symptoms of your adrenal gland condition or disease may go away.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Problems, such as bleeding that cannot be controlled, may happen during your surgery and may lead to a laparotomy (open surgery). Your stomach, intestines, blood vessels, or kidneys may get injured or burned while having the surgery. You could also have trouble breathing, get an infection, or have too much bleeding after surgery. The gas used to expand your abdomen may cause shoulder or chest pain for 1 to 2 days after your surgery.
Without treatment, the symptoms that you have may worsen and cause high blood pressure, or you may have an adrenal crisis. Adrenal crisis is when the symptoms of Addison disease get much worse. These symptoms can put your life in danger. Ask your caregiver if you are worried or have questions about your surgery, medicine, or care.

GETTING READY:

The week before your surgery:

Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
Ask your caregiver if you need to stop using any of your present medicines. If you take aspirin, ibuprofen, or blood thinners, do not stop taking them without asking your caregiver.
If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
X-ray dye may be used during your surgery to help caregivers see your adrenal glands better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may also be allergic to this dye. Tell your caregiver if you are allergic to any of these.
If you are female, tell your caregiver if you know or think you might be pregnant.
You may need to have blood tests, an electrocardiogram (ECG), chest x-ray, and other tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test
You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

The night before your surgery:

Remove any nail polish.
You may be given medicine to help you sleep.
Ask caregivers about directions for eating and drinking.

The day of your surgery:

Write down the correct date, time, and location of your surgery.
Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all medicines that you are taking, including the pill bottles, with you to the hospital.
What to bring: You may want to bring items such as a toothbrush and bathrobe.
If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
Do not wear tight-fitting clothes on the day of your procedure or surgery.
Caregivers will insert an intravenous (IV) tube into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem with anesthesia in the past.
You or a close family member will be asked to sign a legal piece of paper (informed consent). It gives your caregiver permission to do the surgery. It also explains the problems that may happen with the surgery, and your treatment choices. Be sure all of your questions have been answered before you sign this form.

TREATMENT:

What will happen:

You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the operating room and then moved onto a special bed. Your abdomen and genital area will be cleaned and sheets will be put over you. Caregivers will give you general anesthesia to keep you asleep during surgery. A catheter may be inserted to drain your urine. A nasogastric (NG) tube may also be put into your nose and passed down into your stomach.
Two or three small cuts will be made in your abdomen. Caregivers will insert the laparoscope and other tools into the incisions. Your abdomen will be filled with carbon dioxide gas to make it swell. The adrenal gland will be separated from its attachments and removed. The incisions will be closed by stitches or tape, and covered with bandages.

After your surgery: You will be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. Your blood pressure and heart rate will be watched. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you will be taken back to your hospital room. The bandages covering your stitches will keep the area clean and dry to prevent infection.

Waiting room: This is a room where your family and friends can wait until you are ready for visitors. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

CONTACT A CAREGIVER IF:

You cannot make it to surgery on time.
You have a fever (increased body temperature).
Your skin is itchy, swollen, or has a rash.
You have questions or concerns about your surgery.

SEEK CARE IMMEDIATELY IF:

You have trouble breathing or your heart is beating faster.
Your abdomen is tender and hard.
Your vomit (throw up) has blood.
Your signs and symptoms are getting worse.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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