Laparoscopic Adrenalectomy (The James)

Laparoscopic Adrenalectomy (The James)

 

What is a Laparoscopic Adrenalectomy?

The adrenal glands are small organs located on top of the kidneys. These organs make hormones to help the body regulate potassium, blood pressure, fluid balance and the body’s stress response. A laparoscopic adrenalectomy is a surgery done using a thin tube with a light and camera, called a laparoscope to remove both benign (non-cancerous) and malignant (cancerous) adrenal tumors. Three small incisions are made in your abdomen (belly). The laparoscope and other small surgical tools are put through these incisions to remove the adrenal gland.

 

What should I do before surgery?

  • Important Medicine Information

Talk to your doctor about any medicines you take to thin your blood or prevent clots. You may need to change these medicines or adjust the amount you take before surgery. These medicines include:

  • Aspirin
  • Clopidogrel, brand name Plavix
  • Prasugrel, brand name Effient
  • Ticagrelor, brand name Brilinta
  • Apixaban, brand name Eliquis
  • Ticlopidine, brand name Ticlid
  • Warfarin, brand name Coumadin
  • Enoxaparin, brand name Lovenox
  • Dabigatran, brand name Pradaxa
  • Fondaparinux, brand name Arixtra
  • Rivaroxaban, brand name Xarelto
  • Cilostazol, brand name Pletal
  • Edoxaban, brand name Savaysa
  • If you have a stent, do not stop taking your medicines to prevent clots without first talking to the doctor who put in the stent. For more information, ask a member of your health care team for the patient education handout on protecting your stent.
  • If your surgery or procedure is canceled for any reason, call your doctor because you may need to restart the medicines you take to thin your blood or prevent clots.
  • If you take aspirin or medicines like aspirin for arthritis pain, your doctor may have you take a different medicine in the weeks before your surgery.
  • Do not use alcohol and tobacco products for 4 weeks before your surgery.
  • Do not take any herbal supplements for 2 weeks before surgery and for 1 week after your surgery. Your surgeon will tell you when it is okay for you to take them again.
  • Do not drink, eat or chew gum after midnight the night before your surgery.
  • Take only the medicines that your doctor said were okay for you to take on the morning of surgery. You may take these medicines with a small sip of water.
  • Do not wear or please remove these items before your surgery:
    • Nail polish
    • Make up
    • Jewelry, including rings
    • Hair clips or pins
    • Dentures or partial plates
    • Contact lenses or eyeglasses
    • Hearing aids
    • Wig or head covering
    • Body piercings

 

Getting Your Skin Ready for Surgery

Your surgery involves cutting through your skin. Because germs live on everyone’s skin, there is a chance of getting an infection. To lessen your risk of infection, you will be asked to wash your skin with a special foam, called 4% chlorhexidine gluconate (CHG), before your surgery. If you have any questions about cleaning your skin, call your surgeon’s office.

Wash your whole body from the neck down with CHG foam 2 days before your surgery and then again the day before your surgery. Use 4 to 5 pumps of CHG foam each time you shower.

 

How to shower with CHG soap of foam:

Only certain lotions can be put on your skin after you clean it with CHG soap or foam. Ask your nurse for the list of lotions that may be used with this special soap or foam.

 

Day of Your Surgery

When you arrive in the pre-surgical area, the nurse will check your identification (ID) band and ask if you have any allergies. Your vital signs (blood pressure, pulse, temperature and breathing rate) will be taken at this time.

An IV catheter (a long, thin, flexible tube) will be put in a vein in your arm to give you fluid and medicines. You will have lab tests done and your urine checked. If needed, you will receive treatment through the IV catheter to correct any abnormal levels before your surgery.

 

After Surgery

  • After surgery you will be taken to the Post Anesthesia Care Unit (PACU). A nurse will watch you closely and take your vital signs during this time. If you need oxygen, you will have a tube on your face with little prongs in your nose.
  • When you first wake up, you may feel cold and you may shiver. This is normal when you have had general anesthesia. Warm blankets can be given to you. If you have pain, ask your nurse for pain medicine.
  • When you are awake and your vital signs are normal, you will be moved to your hospital room. At this time, your family and friends will be able to visit.
  • On the night of your surgery, your nurse will help you move to a chair and have you walk around your room. You should only get out of bed with help from your nurse, until it is okay to get up on your own. You will be on a clear liquid diet until you can tolerate regular food.
  • A blood cortisol level will be drawn the day after your surgery to determine if you need to take steroid replacement medicine. If both of your adrenal glands are removed, you will need to take this medicine permanently. To help with your healing, your activities will also be restricted for 4 weeks after surgery.
  • Before your leave the hospital, you will be given information on how to care for yourself at home. These directions may include how to take your medicine, how to care for your incisions, what problems to watch for during your recovery and any follow-up appointments.

 

Call your doctor if you have any of the following:

  • Redness or swelling or warmth around your incisions
  • Drainage from your incision site that smells bad
  • Temperature greater than 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
  • Pain in your abdomen (belly)
  • Pain that is getting worse and not relieved by your pain medicine

 

 

© November 7, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.