Laparoscopic Adrenalectomy

Introduction

Adrenal tumors start when abnormal cells change and grow out of control, forming a mass. You can have a cancerous malignant tumour or a benign tumour. Each person has 2 adrenal glands and these glands are very important to the body’s endocrine system.

Indications

• High blood pressure.
• High blood sugar.
• Weight regain, usually greater around the collar bone and around the abdomen.
• Irregular periods.
• Frequent urination.

Procedure

Removal of a tumour in or on the adrenal gland.

Post-operative Instructions

Pain

Post-operative pain is normal but the intensity can differ between individuals. Analgesia will be given to you during your hospital stay and made available to you on your discharge if still required. Please read section “Medications”.

Wound / sutures / swelling

Keeping your wound clean and dry will help to prevent infection. Your stitches will be dissolvable. All wound dressings are to be left intact for 10 days after surgery. Please be aware that dressings can sometimes cause allergic reactions. In this instance remove the dressing and leave the wounds uncovered.

Diet

A normal fluid intake and diet is commenced after your surgery. It is important to have a diet high in fibre and stay well hydrated to help avoid constipation.

Nausea and vomitting

Some people are very sensitive to surgical procedures. Nausea and vomiting may occur as a result of the general anaesthesia, the procedure performed or the medications prescribed. If you have nausea and vomiting please do the following:

• Keep well hydrated with frequent small drinks of clear fluids. It is recommended that you drink water, lemonade or diluted fruit juice. Avoid milk.
• Cease your medications as in most cases the nausea and/or vomiting is related to the pain killers prescribed. Once these have been ceased the nausea and/or vomiting will usually resolve.
• Contact Dr Daoud’s office at Greenslopes if the nausea and/ or vomiting persists.

Medication

You will generally be prescribed pain killers. It is imperative that you notify Dr Daoud of any allergies you have to medications. If you are taking medications prescribed by your doctor you need to return to your normal dosage schedule as soon as possible after surgery unless directed otherwise.

Activities

24 hours after your surgery you MUST NOT drive any motor vehicle or operate machinery. You MUST NOT undertake any important new projects, make important decisions or sign legal documents. You MUST NOT drink any alcohol. Alcohol and prescribed medication is a dangerous mix. You are not to drive for one week and not participate in any contact sport for four weeks. You should gradually return to normal activities within 2 weeks.

Return to work / school

You can expect to return to a normal routine after 14 days. If you require a medical certificate, please call Dr Daoud’s office after your surgery and one will be arranged.

Postoperative appointment

You will need to contact Dr Daoud’s office once you are discharged to make a post-operative appointment for 4 weeks after your surgery.

Infection

If you develop a post-operative infection remember it will not generally appear until one to two weeks after the operation. If this does occur, please call Dr Daoud’s office to book a review appointment. You will normally be prescribed a course of antibiotics.

It is important that the full course of antibiotics is completed.

Problems

Post-operative complications such as infection, unusual pain, etc are uncommon but if they do occur please contact Dr Daoud for advice.

Please feel free to call Dr Daoud’s rooms during office hours or mobile after hours if any doubt arises as to your progress or recovery, especially if any of the following occurs:

• Increasing or persistent pain after 4 or 5 days.
• Any swelling around the wound site.
• Persistent nausea or vomiting.
• Persistent discharge from the wound site.

Please do not call the referring doctor or your local general practitioner before you call Dr Daoud. Most problems can be solved by calling our office on 07 3397 8499. If you are concerned outside of office hours, please present to the closest emergency department.

Risks/Complications

• Depending on the type of lump found, profound changes may occur with blood pressure during the operation, which may cause complications with the heart or the circulation to the brain.
• Major blood vessels around the tumour may be damaged. This could cause profuse bleeding during or after the operation. This may require further surgery and a blood transfusion
• Damage of the bowel may occur which may cause leakage of bowel fluid. This may require numerous surgeries, formation of stoma, scarring and a long hospital stay.
• Especially in a male there may be difficulty passing urine and a tube may need to be inserted into the bladder until the bladder is able to empty normally.
• Infections such as pus collections can occur in the abdominal cavity. This may need surgical drainage.
• The bowel movement may be paralyzed or blocked after surgery and this may cause building up of fluid in the bowel with bloating of the abdomen and vomiting. Further treatment pay be necessary for this.
• A weakness can occur in the wound with complete or incomplete, bursting of the wound in the short term or a hernia in the long-term. Further surgery may be needed.
• In some people healing of the wound may be abnormal and the wound can be thickened and red and the wound may be painful.
• Adhesions (bands of scar tissues) may form and cause bowel obstruction. This can be short term or a long-term complication and may need further surgery.
• If both sides need surgery, then long-term medication will be necessary.
• For obese people, there is an increased risk of wound infection and chest infections, heart and lung complications and thrombosis.
• For smokers, there is an increased risk of wound and chest infections, heart and lung complications and thrombosis.