Dr. Sarah Joy Hill, 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.

During the procedure, the surgeon inserts the laparoscope, which contains a light and camera that allows the surgeon to see what is happening inside the body. Then tiny tools are placed through the small openings and used to perform the surgery.

The most common laparoscopic surgery is gallbladder removal, but laparoscopic surgery may also be used for the removal of a kidney or appendix, to treat certain cysts and tumors, for bariatric surgery, for some GERD treatments, or for hernia repairs, among others.

Because laparoscopic surgery only uses a few tiny incisions, the scars are minimal and recovery is easier than with open surgery.

Both hypothyroidism and goiters are caused by an autoimmune reaction where the body produces antibodies that attack the thyroid cells for unknown reasons. The thyroid reacts by releasing too little or too much T3 and T4 thyroid hormones, impairing thyroid function and causing irregular metabolism. Goiters develop from the autoimmune reaction causing continued antibody damage to the thyroid over time. Thyroid goiters are large, swollen lumps that can be felt near the base of the neck. Obstructive goiters can cause pain, coughing, and abnormal breathing. Hypothyroidism may also be caused by iodine deficiency, as iodine is needed to produce thyroid hormones.

The exact cause of thyroid cancer and thyroid nodules or cysts is unknown. While thyroid cancer and thyroid nodules or cysts can occur in individuals with thyroid disorders, they are not associated with a malfunctioning thyroid.

Physicians may prescribe thyroid surgery if blood tests reveal patients' thyroid stimulating hormones (TSA) are outside of the acceptable range, indicating a malfunctioning thyroid. Thyroid biopsies (tissue samples) and tests for thyroid-attacking antibodies are also criteria for surgery.

An ENT or general surgeon performs thyroid surgery. While a patient is placed under anesthesia, the surgeon makes an incision at the center of the neck and removes the thyroid gland. Two alternative methods of thyroid surgery are transoral (incision through the mouth) and endoscopic, where a surgeon operates a video camera for live footage to help guide the removal process.

Thyroid surgery requires minimal aftercare. Most patients recover quickly and resume normal activities within a few days of surgery. However, thyroid surgery patients must take daily synthetic thyroid medication (levothyroxine) for life to replace their removed thyroid.