Dr. Richard Zheng, 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.

Liver resection can be performed laparoscopically or through open surgery. Laparoscopic liver resection is a minimally invasive surgery that requires a few tiny incisions on the abdomen, through which the surgeon inserts a thin tube with a camera (laparoscope). Open hepatectomy is performed through a laparotomy, which makes one large incision on the abdomen. Although a laparoscopic liver resection is associated with less pain and quicker recovery, patients may have to undergo an open liver resection depending on factors such as the location of the tumor and previous abdominal operations they have had.

After the liver resection, patients will stay in the hospital for up to six days. The recovery period will vary based on how much of the liver was removed. Limiting consumption of alcohol and light physical activity, such as walking, can help patients to have a speedy recovery.

Small bowel resection can be done through either a laparoscopic or open approach. If someone is having a laparoscopic small bowel resection, their surgeon will make multiple small incisions on the abdomen and insert a thin tube with a camera, called a laparoscope. If they are having an open small bowel resection, a large cut is made on the abdomen to expose the intestine. A laparoscopic small bowel resection is associated with less pain and requires a shorter recovery period, but depending on the condition, patients may have to undergo an open procedure.

After making the necessary incisions, the surgeon will remove the targeted portion of the intestine and then perform an anastomosis. Depending on the amount of intestine left, an anastomosis may involve the surgeon either joining together the ends of the intestine or creating a stoma which is an opening in the abdomen. In this procedure, called an ileostomy, the end of the small intestine (ileum) is attached to the opening in the abdominal wall. A drainage pouch will be attached to the skin to collect waste.

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

Small bowel resection is typically completed in one to four hours. After the operation, patients will need to stay in the hospital for a few days, and it may take some time before they can return to their normal diet.