Preparations for adrenalectomy

Everyone should know that this operation isn't something you can schedule for a next day! It is extremely important to point out that every patient which is candidate for an adrenalectomy normally needs extensive drug treatment prior to surgery. This sometimes last for several weeks, but in most cases, about a week. This is also accompanied with several blood, urine and other tests. Only after all these tests, a candidate is considered safe and prepared for the adrenalectomy.  

 

Open adrenalectomy
 

It is important to point out that the surgeon has a freedom to operate from almost any possible direction because it can depend on the patient’s type of body or on the exact medical problem. The most common is the anterior approach, where the surgeon approaches the gland through the front abdominal wall. Usually the incision will be horizontal, just under the rib arc. Only in few cases - a vertical incision can be done only with purpose to provide a better approach, especially if both adrenal glands are involved. When we talk about a posterior approach, we should know that, in this case- surgeon makes an incision on the patient’s back, sometimes on one and sometimes on each side of the body. Although, there are many surgeons that favor this approach, because it is a lot easier to perform, the fact is that this approach does not provide quite as clear a view of the surrounding structures as the anterior approach.

Just to be noted, a flank approach is also possible but it is rarely done. Only indication is patient’s obesity! 

The last, but the most rarely used approach is the thoracic approach where the incision is made into the chest cavity. Only indication for this kind of operation is the situation when we talk about a very large tumor.

 

Laparoscopic adrenalectomy
 

Almost everyone has heard about the laparoscopic surgeries because this technique has been very popular these last couple of years because of minimal scarring and shorter recovery time! Like it is well known, this technique does not require opening of the body cavity, but making four small incisions which are made into a patient's flank, just under the rib cage. What exactly is a laparoscope? Well, it is one instrument which enables the surgeon to visualize the inside of the abdominal cavity on a television monitor.

What Happens during an Adrenalectomy

Here are some hints about what is being done during the adrenalectomy. Well, the first rule is that it is always done in general anesthesia. Like with any operation of this importance, just before the operation, patient is given a lot of heparin, a drug that should prevent blood clotting. The main thing is to remove the tumor from the patient’s body, never mind the size of it. In most cases, several days after the operation, patient is caring a small tube in the nose for several days, in order to keep the stomach empty, which could be extremely important. Because adrenal gland is very hormone –productive, it is possible that, during the operation, blood pressure drops significantly. That’s why, during the operation, drugs will be given to maintain the blood pressure.