Overview
A laparoscopic adrenalectomy is a minimally invasive surgical procedure to remove an adrenal gland tumor. Removing an adrenal gland using a laparoscope allows direct visualization of the gland and the surrounding tissues through smaller more precise incisions.
Why it’s done
Your veterinarian may recommend an adrenalectomy if your pet has:
- Ultrasound or CT scan findings of a tumor of the adrenal gland
- Lab work consistent with hormonally active tumors of the adrenal gland that can lead to extremely high blood pressure, collapsing episodes (pheochromoctyoma), or Cushing’s disease.
How to prepare for your pet’s procedure
Before your pet’s laparoscopic adrenalectomy, you will meet with one of our specialists to talk about the procedure and what to expect.
When you meet with our team, please bring a list of all medications that your pet is currently taking, including over the counter medications, vitamins, and herbal supplements. Before your pet’s procedure, you may be asked to discontinue giving certain medications that can increase the risk of bleeding. You may be instructed to begin certain medications prior to your pet’s procedure. Phenoxybenzamine is often administered for approximately 1 week before an adrenalectomy in the case of a pheochromocytoma.
This is a good time to ask questions about the procedure and make sure you understand the risks and benefits.
Preoperative diagnostics and tests
Before your pet’s biopsy the following may be indicated:
- Abdominal ultrasound
- A comprehensive blood panel
- Hormonal tests for Cushing’s disease and pheochromocytoma
General Instructions for the Day of Surgery
- Please remove your pet’s access to food as of midnight the night prior to surgery, but do allow water all night long.
- Please arrive for pet’s admission promptly at your scheduled arrival time.
- You will be asked to sign both a Surgical Consent Form as well as an Estimate, indicating your understanding of the procedure, risks, and associated costs.
What happens during a laparoscopic adrenalectomy procedure?
Your pet will be given a general anesthetic. Special instruments, including a camera, are passed through small ½ inch incisions into the abdomen. The specialists can visualize the adrenal gland and remove it. The adrenal gland is then withdrawn from the abdomen through one of the small incisions. The small incisions are closed with dissolvable stitches under the skin.
Risks
Complications associated with a laparoscopic adrenalectomy can include the following:
- Bleeding
- Blood pressure irregularities
- Arrhythmias (irregular heart rhythm)
- Electrolyte abnormalities
- Acute adrenal insufficiency (Addison’s disease)
After the procedure
- Following the procedure, you will be given a phone call with an update on your pet’s recovery.
- Please plan for your pet to remain hospitalized for pain management, supportive care, and monitoring for 2-4 days post operatively.
- Once discharged the following instructions are advised:
- Please remove the bandage from your pet’s intravenous catheter site 10 to 15 minutes after arriving home.
- Some abdominal tenderness is common for 3-5 days following laparoscopic surgery.
- It is important to restrict your pet’s activity for the next 3-5 days while the incision is healing. Walks should be short and your pet should always be on a leash. Please do not let your pet rough house with other animals during this time.
- Suture removal is generally not necessary, as dissolving stitches will often be placed.
- Please monitor the incision for any signs of heat, pain, swelling, or discharge. Should you notice any of these signs, it may be an indication of infection. Please call Salt River if you notice a problem.
- Licking or scratching at the incision will dramatically increase the chances of an infection or that the incision will open up. To prevent this from happening, please watch your pet closely for scratching or licking at the incision. If this occurs, an e-collar should be placed.
Results
The adrenal gland will be submitted to a specialized laboratory for evaluation.
The final biopsy results can take up to 2 weeks. Once the final results have returned and a treatment plan has been devised, our specialists will call you to discuss the findings and recommendations.
Follow up
A recheck examination is required in 7-10 days.