WHAT ARE THE SUPRARRENAL (ADRENAL) GLANDS AND WHAT FUNCTION DO THEY HAVE?

The adrenal glands are two endocrine glands (right and left) located in the depth of the abdomen, protected by the spine, ribs, kidney and abdominal viscera. Their primary function is to secrete a wide variety of hormones which are necessary to regulate body temperature, blood pressure, character, sleep-wake patterns, appetite, emotions and even sex. The importance of these glands lies in the fact that small hormonal alterations can produce serious disorders and diseases.

The importance of these glands lies in the fact that small hormonal alterations can produce serious disorders and diseases.

 

What problems can occur?

Dysfunctions of the adrenal glands can occur.

Usually adrenal tumours do not give any symptoms and so they tend to be diagnosed incidentally (they are occasionally found when looking for another disease).
Sometimes it is necessary to operate to remove the adrenal. This happens in benign tumours larger than 4 cm, all tumours that produce an excess of hormones (Conn's Syndrome, pheochromocytoma) and in adrenal cancer. At times metastasis from other cancers may also appear.

Adrenal cancer is rare but very aggressive. If cancer is suspected, it requires immediate surgery when the complete removal of the tumour can be guaranteed.

Adrenal tumors of > 4 cm require surgery.

 

DOES ADRENAL SURGERY LEAVE VISIBLE SCARS?

The surgical procedure to remove an adrenal tumour does leave visible scars, but they are minimal.

Whenever possible, we will perform the operation by laparoscopy or retroperitoneal endoscopy. To remove this type of tumour we will need to make three to four incisions of approximately 1 cm.

The surgical procedure to remove an adrenal tumour does leave visible scars, but they are minimal.

 

IS IT IMPORTANT WHO PERFORMS THE SURGERY AND WHERE THIS TAKES PLACE?

It is of the utmost importance.

Surgery of adrenal tumours must be performed by expert teams in Endocrine Surgery and at the same time experts in minimally invasive endoscopic surgery (laparoscopy and retroperitoneal endoscopy). This is the only way that an optimal result can be guaranteed with the patient's total recovery without side effects.

To a great extent, the healing of an adrenal tumor depends on the surgical procedure performed.

 

WHICH APPROACH IS THE BEST?

The surgical procedure to remove the adrenal glands can be done through two approaches: Transperitoneal or Retroperitoneal. We can offer either of these two approaches according to the patient's needs.

Transperitoneal laparoscopy (through the abdomen): We perform the intervention using minimally invasive techniques, both standard laparoscopy, mini-instruments as well as single-port surgery (SILS) for an impeccable aesthetic result.

There are patients in whom a standard laparoscopy can be difficult, problematic or even unadvisable to carry out due to their characteristics (obesity), their medical history (abdominal operations, stomata, abdominal visceral cancer, liver cirrhosis ...). In these cases, we are able to perform the procedure from "behind".

Retroperitoneoscopy (through the back): We perform the same procedure, but from the retroperitoneal space, avoiding contact and manipulation of the abdominal viscera. Despite being a more complex technique that requires more technical training, it offers obvious advantages for most patients, such as a shorter hospital stay, less postoperative pain and a lower risk of abdominal complications.

Retroperitoneoscopy offers obvious advantages for most patients: a shorter hospital stay, less postoperative pain and a lower risk of abdominal complications.

 

SURGERY BY LAPAROSCOPY

SURGERY BY LAPAROSCOPY

DOES ADRENAL SURGERY REQUIRE HOSPITAL ADMISSION?

You will probably be able to go home approximately 24-48 hours after the operation. On some occasions, the patient must be admitted for more days.

You can probably go home 24-48 hours after the operation.

 

WHAT WILL I NOTICE IN THE POST-OPERATIVE PERIOD?

After a laparoscopic or retroperitoneoscopic adrenalectomy you may notice some transient discomfort in your throat due to the plastic tube which was inserted into the trachea to administer anesthesia.

Because of the body's position in the operating theatre, you may also feel some discomfort similar to stiffness.

You will notice pain and a certain tension in the area of the scars, as well as a certain sensation of abdominal swelling if your surgery involved a laparoscopy.

These symptoms have a short duration of approximately 2 weeks and practically never need treatment.

You will notice pain and a certain tension in the area of the scars, as well as a certain sensation of abdominal swelling if you have received surgery by laparoscopy.