Dr. Sabrina Esther Drexel, MD

Adrenal surgery can be open or laparoscopic. Laparoscopic adrenalectomy is a minimally invasive procedure that inserts a thin tube with a camera (laparoscope) through several small incisions on the abdomen. The surgeon uses the laparoscope to guide the procedure and is able to access and remove adrenal glands through the small incisions. Laparoscopic adrenal surgery lasts approximately 1-2 hours.

Laparoscopic adrenalectomy is associated with shorter recovery periods, reduced risk of infection, and smaller scars. Although these factors may be desirable, the location of the tumor, its size, and the severity of the condition may require that an individual instead undergo open surgery. An open adrenalectomy is typically done for larger adrenal tumors and requires a single, large incision on the abdomen. Open adrenal surgery takes around 2-4 hours.

Following the operation, patients will remain in the hospital for 1-2 days for a laparoscopic adrenalectomy or 3-5 days for an open adrenalectomy. Patients will likely have a liquid diet immediately after their surgery, but should be able to return to solid foods after a day. If both of the glands are removed, patients will be given drug therapy to replace the hormones they produced.

A colectomy may be performed by laparoscopic or open surgery. A laparoscopic colectomy requires several small cuts on the abdomen, and uses a thin tube with a camera, called a laparoscope. Laparoscopic colectomies are less invasive than open procedures. For some individuals, a laparoscopic colectomy may not be possible, and instead an open colectomy is performed. In an open colectomy, a large incision is made on the abdomen. Open colectomies typically require longer recovery periods.

After the incisions are made, a portion of the colon is removed, and the remaining ends of the colon are attached to each other in a procedure called anastomosis. Waste can continue to travel through the body as normal. However, in some situations, it may be necessary for the end of the colon to be attached to an opening in the abdomen, called a stoma. This procedure is called an ostomy. Types of ostomies include:

• Colostomy, in which the remaining portion of the colon is attached to the abdominal opening.
• Ileostomy, in which the small intestine is attached to the abdominal opening.

An ostomy bag will be attached to the skin to collect waste. If the entire colon is removed, either an ileostomy is performed, or the small intestine is connected to the anus and waste may pass through as normal.

Stomas may be permanent or temporary. If the stoma is temporary, the ends of the colon will be rejoined in a later procedure. Temporary stomas are generally used to allow time for the colon to heal following surgery.

A colectomy may take between one and four hours. Following the procedure, patients will need to consume a liquid and low fiber diet before gradually returning to their normal diet. Patients will need to stay in the hospital for three to seven days for monitoring. Full recovery and return to normal activity may take anywhere from a few weeks to several months.

Patients may be asked to drink only liquids in the days before a colonoscopy, or they may be given an enema to remove residual fecal matter. Before the exam, patients are given medication to help them relax, and then lay on their side on a table. The scope is inserted into the anus and gently moved all the way through the large intestine. Air may be pumped into the intestine to improve the view for the physician. Any polyps that are found will be removed. Then the colonoscope will be withdrawn. A colonoscopy is not usually painful, but patients may feel some bloating or have some cramps right afterward. If patients have polyps removed, they might experience a small amount of bleeding. Any side effects should go away within a few hours.