Medical services

Adrenal surgery

In medical practice, adrenal gland surgery is considered the most difficult. To conduct it successfully, the doctor must have high skill and experience in surgery. Before choosing a technique for treating adrenal glands, the doctor should conduct a range of laboratory and instrumental studies. Only after that, he can fully begin surgical intervention.

The adrenal glands are vital organs of the endocrine system. They produce a large number of necessary hormones, namely glucocorticoids, minerals, adrenaline, norepinephrine and sex hormones. If you take the thyroid gland, you can replace it with the functions of the adrenal gland, but you can not make the process reverse.

Adrenal insufficiency occurs as a result of long-term treatment or removal of adrenal tissue. As a result of the development of such a pathological process, the patient needs to take drugs throughout his life, which will help the adrenal glands to work fully.

Therefore, to conduct surgery on the adrenal glands, the patient must have a number of serious indications, we will tell about them a little later. The main indication for surgery on the adrenal glands is the tumor process in the adrenal tissues and directly in the organ itself. Recently, doctors have begun to increasingly diagnose bulk tumors in this particular organ. Why is this happening?

The fact is that it cannot be argued that it was the tumor processes that began to appear more often, just in recent years, medicine has reached a high level, that it is possible to diagnose various changes in organs in time. Previously, there was no such possibility, and people died without knowing the true cause of their illness.

Time to diagnose diseases of the adrenal glands can be using ultrasound and computed tomography. What is most interesting, with the help of computed tomography it is possible to diagnose a pathological process in the adrenal glands at the time of viewing a completely different organ located in the abdominal cavity. Such cases, of course, are not so common, but are still present. Similar points in medicine are called insidendom.

Previously, doctors did not really think about the method of treatment of such diseases. If a person was diagnosed with a tumor process in the adrenal glands, then according to the standard, surgical intervention was prescribed. Today, the doctors have slightly revised their attitudes towards this problem and decided that they should not immediately resort to such aggressive methods of treatment.

When do doctors prescribe an adrenal surgery?

In the adrenal glands, not only the tumor process can occur, but also much more. Doctors will help patients with surgery:

  • pheochromocytoma;
  • Conn's syndrome;
  • adrenocortical cancer;
  • adrenal adenoma of a different nature;
  • lymphoma
  • myelolipoma;
  • cyst;
  • metastases.

If a patient has at least one of the above listed diseases, he is urgently prescribed surgery.

How to prepare for surgery?

Before prescribing surgery, the patient is sent for additional diagnostics, which consists in:

  • full medical examination;
  • general blood test;
  • urinalysis;
  • ultrasound of the abdominal cavity;
  • computed tomography;
  • magnetic resonance imaging;
  • radiation scanning.

Also, before the operation, the patient is forbidden to drink all medications in order to find out the true cause of the adrenal gland malfunction.

These drugs include aspirin or other anti-inflammatory drugs and drugs that can thin the blood.

Before surgery, no food should be taken for 7 hours. Doctors recommend on the night before surgery to do an enema or take medicines with a laxative effect. In this way, you can cleanse your intestines. Before starting an operation, it is very important to measure blood pressure indicators. At elevated pressure, adrenal gland surgery is strictly prohibited.

How is the operation performed?

First, the patient is given general anesthesia so that during the operation the patient is asleep. As soon as the patient falls asleep, he needs to introduce antibacterial agents and appropriate hormones.

If the adrenal gland is large enough mass, then the removal occurs through the front wall of the abdominal cavity. In this way, it is easier for doctors to get the adrenal gland out of the human body. If there is concomitant evidence, then experts further examine the other organs that are in the abdominal cavity.

Cuts can only be made in the abdominal cavity or chest. It is very important to properly separate the diseased organ from the kidney. As soon as the organ is reached, they immediately begin to suture the incision. The faster this is done, the less likely it is to wound infection. After suturing, a sterile dressing is applied to the area to be operated. If necessary, the doctor can insert a special tube in the place where the gland was removed. This will remove excess fluid from the body.

Typically, the process takes seven days. After that, they pick up the phone. An operation lasts an average of two to three hours. It may take longer if there are concomitant complications.

The operation is absolutely painless, because the patient is under general anesthesia during the procedure.

Postoperative period

After doctors remove the adrenal gland through the incision, the patient is sent to the postoperative room. Here he will stay until he moves away from anesthesia. The removed organ is sent for laboratory research to exclude or confirm the moment of malignancy.

As soon as the anesthesia begins to move away, the patient will feel a slight twitch at the incision site, but soon it will pass. If the patient complains of pain, then he is prescribed pain medication. After surgery, if there are no serious complications, the patient is in the hospital for no more than five days. At home, the patient must strictly comply with all the recommendations of the attending physician. Otherwise, serious complications may begin.

Watch the video: A New Approach to Surgery of the Adrenal Gland: Laparoscopic Retroperitoneal Adrenalectomy (November 2019).