Adrenalectomy

Adrenalectomy is performed to remove a tumor in one of the adrenal glands, the small, triangle-shaped organs that sit on top of the kidneys in the back of your upper abdomen. The adrenal glands produce several hormones and chemicals, including estrogen, progesterone, cortisol, cortisone, steroids, adrenalin (epinephrine) and norepinephrine. An adrenal tumor may require removal if it is large, suspected or confirmed to be cancerous, or making the gland produce too much of one or more of the above-mentioned substances. Because the adrenal glands are so small, they usually must be removed entirely in order to remove the tumors.

Laparoscopic adrenalectomy not only offers candidates less postoperative pain and a faster recovery, it also produces smaller scars (three or four incisions of 1/4- to 1/2-inch instead of a single 6- to 12-inch incision) and a lower risk of wound separation or hernia after surgery. Under general anesthesia, the surgeon inserts small tools and a camera into the abdomen and carefully removes the adrenal gland.

Adrenal Cancer

The adrenal glands sit on top of the kidneys in the back of your upper abdomen. These triangle-shaped glands produce several hormones and chemicals, including estrogen, progesterone, cortisol, cortisone, steroids, adrenalin (epinephrine) and norepinephrine. Tumors can make the adrenal glands produce too much of one or more of these substances. People with adrenal tumors may experience a variety of symptoms from excess hormone production, or they may feel pain in the abdomen or flank.

Adrenal tumors are rare, and adrenal cancer is even rarer, affecting only one or two people in a million. Most adrenal tumors are benign (non-cancerous). Adrenal cancers are classified based on the part of the gland in which they're found. Cancers occurring in the outer layer, or cortex, are called adrenocarcinomas; cancers that form in the inside, or medulla, are known as either pheochromocytomas or neuroblastomas.

Adrenal cancer is aggressive, but it can be cured if it is caught before it spreads to other organs. The standard treatment is surgical removal of the tumor. For some people with advanced cancers, radiation therapy or chemotherapy may be recommended along with surgery.

Pancreatitis

Pancreatitis is an inflammation of the pancreas, the long, flat gland between the small intestine and spleen that secretes enzymes to digest food and secretes insulin and glucagon. When inflamed, the enzymes become active and attack the pancreas. Pancreatitis can be an acute or chronic condition that may cause mild to severe symptoms, both of which can usually be treated.

Pancreatitis is believed to be caused by a combination of environmental and genetic factors, but heavy alcohol consumption is a leading cause of both acute and chronic cases. Gallstones can also cause acute pancreatitis by blocking the pancreatic duct.

Symptoms of pancreatitis can vary depending on the type and severity of the condition, but common symptoms include:

• Pain in the upper abdomen
• Chest pain
• Nausea and vomiting
• Fever
• Rapid pulse
• Dehydration

Pancreatitis can be diagnosed through a combination of blood test, stool test, pancreatic function test and imaging techniques. Treatment for this condition is important because if untreated, it can lead to infection, respiratory failure, diabetes and shock. The type of treatment depends on whether the condition is acute or chronic and aims to relieve symptoms and eliminating probably causes. Common treatment options include hospitalization, alcohol abuse treatment, pain relief, enzyme therapy and diet changes. Avoiding alcohol, smoking and foods high in fat can help reduce your risk of pancreatitis.

Pancreatic Resection

Pancreatic resection removes part or all of the pancreas, a gland located behind the stomach that produces enzymes that help digest food and hormones that help regulate blood sugar. It offers the opportunity for a cure for patients with pancreatic cancer, which is often not detected until it is quite advanced. The goal of resection is to remove all traces of cancerous tissue while preserving as much of the pancreas, bile duct and/or duodenum (upper part of the small intestine) as possible. However, in some cases these must be removed, sometimes along with part of the stomach, in an operation called a Whipple procedure. Because it is a rare and technically difficult procedure, the best outcomes are achieved by those surgeons who have performed many pancreatic resections.

Pancreatic Cancer

Pancreatic cancer develops in the pancreas, the long, spongy organ in the lower part of the stomach that helps with digestion and produces insulin to aid the metabolic system. Pancreatic cancer is one of the leading causes of cancer deaths because it tends to spread rapidly and is not easily detected.

Symptoms of pancreatic cancer do not usually occur until the disease has progressed to its advanced stage, if at all. Some people may experience yellowing of the skin and eyes, known as jaundice, as well as pain in the upper abdomen, nausea, loss of appetite and weakness.

Pancreatic cancer develops as a result of a genetic mutation within the pancreatic cells, causing them to grow uncontrollably and eventually form a tumor. As with other cancers, smoking, obesity and a family history of the disease may increase the risk of pancreatic cancer.

There are currently no screening tests available for pancreatic cancer, which makes early diagnosis difficult. If your doctor suspects pancreatic cancer, you may undergo a series of diagnostic tests such as an ultrasound, CT scan, MRI, endoscopy or biopsy.

Once diagnosed, treatment to eliminate the cancer or prevent it from spreading can begin immediately. Unfortunately, most cases of pancreatic cancer cannot be surgically removed. Chemotherapy, radiation therapy or targeted drug may also be used to treat the disease. New methods are currently being tested to effectively treat pancreatic cancer and improve the prognosis of this life-threatening disease.

Thyroid Surgery

Located in the neck just below the larynx, the thyroid gland regulates your body’s energy levels and releases hormones that regulate your metabolism. Thyroid hormones influence virtually every organ system in the body, telling organs how fast or slow they should work. Thyroid hormones also regulate the consumption of oxygen and the production of heat.

Thyroid surgery is used to treat a variety of thyroid conditions such as thyroid cancer, thyroid nodules, and hyperthyroidism (an overactive thyroid gland).

Reasons for Having Thyroid Surgery

Hyperthyroidism - Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone, speeding up the body’s metabolism. Symptoms include:

• Fatigue
• Rapid heartbeat
• Weight loss
• Diarrhea or frequent bowel movements
• Irritability and anxiety
• Intolerance to heat and increased sweating
• Vision problems
• Menstrual irregularities
• Infertility

Hyperthyroidism is usually treated with anti-thyroid medication, which decreases the production of thyroid hormone in the body, and/or beta-blockers, which help control symptoms. Another medication, radioactive iodine, acts by breaking down the thyroid.

If hyperthyroidism cannot be treated with medication, surgery is recommended.

Thyroid Nodules - A thyroid nodule is a small swelling or lump in the thyroid gland and is fairly common. These nodules are either a growth of thyroid tissue or a fluid-filled cyst. Surgery is needed if the thyroid nodule is large enough to cause problems with breathing or swallowing. If a nodule is fluid-filled, your doctor may be able to drain it. However, if the nodule returns after drainage, it may have to be surgically removed.

Thyroid Cancer – If cancer is present or suspected in the thyroid, surgery is a must. This is often accompanied by follow-up treatment with radioactive iodine to prevent the cancer from returning.

Types of Thyroid Surgery

Depending on the type of surgery, you may need to have all or part of the thyroid removed.

Lobectomy - If nodules are located in only one lobe of the thyroid, your surgeon will remove that lobe alone. With a lobectomy you may also need an isthmectomy, in which the narrow band of tissue (isthmus) that connects the two lobes is also removed.

Subtotal (near-total) Thyroidectomy - Removal of one complete lobe, the isthmus, and part of the second lobe.

Total Thyroidectomy – Removal of the entire gland (both lobes and the isthmus) and the lymph nodes surrounding the gland.

Recovery from Thyroid Surgery

Thyroid surgery can take up to 2 ½ hours. After the procedure you may feel soreness in your throat because of the breathing tube that was inserted. You will be hospitalized for about 24 hours following the operation and will be able to return to normal day-to-day activities the next day. You should not engage in strenuous activities, such as heavy lifting or vigorous sports, for at least 10 days after the operation.

Expectations after Thyroid Surgery 

Thyroid surgeries are often very successful. Afterwards, you will be able to do everything you did before you had the surgery.

Many patients develop hypothyroidism (decreased thyroid activity) after surgery, which requires treatment with thyroid hormone. This is more common in surgeries for thyroid cancer.

The success of a thyroidectomy to remove thyroid cancer depends on the type of cancer and whether it has metastasized (spread) to other parts of the body. You may need follow-up treatment with radioactive iodine to treat cancer that has metastasized or to help prevent the cancer from returning.

Risks and Complications

Thyroid surgery is generally a safe procedure, but complications may occur. The nerves controlling your voice can be damaged, resulting in hoarseness and a change of voice. Also, bleeding can occur, causing acute respiratory distress. Hypoparathyroidism (decreased parathyroid activity) may also occur if the parathyroid gland is damaged during surgery. These risks are more common in more invasive thyroid procedures involving extensive lymph node involvement, large goiters, and invasive tumors.