Download Multidisciplinary Adrenal Care

department of surgery
Remarkable People. Remarkable Results.
University of wisconsin school of medicine and public Health
Multidisciplinary
Adrenal Care
A
t UW Health, we offer multidisciplinary adrenal care to meet the needs
of patients with adrenal disease. Our team of surgeons works hand-inhand with endocrinologists, radiologists, oncologists and interventional
radiologists to determine the best course of care for each patient.
What are common diseases of the adrenal glands?
The adrenal glands are two small glands that are located on top of each kidney. The
main role of the adrenal glands is to make hormones such as adrenaline or steroids.
Normally, only one or part of one adrenal gland can produce enough hormones
for the body. Often, patients are referred for an adrenalectomy after an abdominal
CT scan reveals an incidental adrenal nodule or an enlarged adrenal gland.
Common conditions include:
• Incidental adrenal nodules (revealed by abdominal CT)
• Pheochromocytoma
• Cushing’s Syndrome
• Hyperaldosteronism
• Adrenocortical carcinoma (rare but needs to be treated aggressively)
Treatment Options
Medical and surgical treatment options are available. Laboratory tests, imaging and
sometimes venous sampling play a role in determining which course of treatment is
appropriate for each patient. Surgical removal of an adrenal gland (adrenalectomy)
is most commonly performed for a tumor located within the adrenal gland that is
either producing too many hormones or is potentially cancerous.
Laparoscopic Adrenalectomy
The most common surgery performed is a laparoscopic adrenalectomy. With
laparoscopic adrenalectomy, surgery occurs through three or four small incisions
measuring less than 0.5 inches. Most patients go home the day after surgery with
minimal pain and many return to work within seven to 10 days.
uwhealth.org/endocrinesurgery
To make an appointment for an
adrenal evaluation, please call
(608) 263-7502.
Remarkable People. Remarkable Results.
Multidisciplinary Adrenal Care continued
Who is a candidate for laparoscopic adrenalectomy?
Who is a candidate for retroperitoneal adrenalectomy?
Traditionally, only small tumors were treated with laparoscopic
surgery. UW Health surgeons have successfully treated very
large tumors (9–10 cm) laparoscopically. Each case is tailored
to the specific patient and tumor characteristics.
This minimally invasive approach can be used for patients
having both glands removed and those with extensive
abdominal scar tissue from previous surgery.
What are the benefits of laparoscopic adrenalectomy?
• Smaller incisions
• Less pain
• Less scar tissue
• Faster recovery and return to work
Retroperitoneal Adrenalectomy
Surgeons may also perform a retroperitoneal adrenalectomy,
during which the patient is lying face down and three small
incisions are made, measuring less than 0.5 inches. In this
position, the adrenal glands lie against the ribcage in the
back and are easily accessible.
What can a patient expect following surgery?
Most patients take off up to one week from work and return
to their normal level of functioning within one to two weeks.
After surgery, the patient may shower and eat a normal diet.
Patients are seen in the surgery clinic one to two weeks after
surgery. Further follow-up with the surgeon or endocrinologist
may be needed depending on the specific disorder.
Are there side effects following adrenalectomy?
If only one of the adrenals is removed, there are usually no
side effects or need for hormone replacement. In rare cases
where both adrenal glands are removed, the patient will
require hormone replacement.
Herbert Chen, MD
David Schneider, MD
Rebecca Sippel, MD
Professor
Division of General Surgery
Assistant Professor of Surgery
Division of General Surgery
Associate Professor of Surgery
Division of General Surgery
Clinical Science Center, K3/705
600 Highland Ave.
Madison, WI 53792-3284
Clinical Science Center, K4/738
600 Highland Ave.
Madison, WI 53792-3284
Clinical Science Center, K3/704
600 Highland Ave.
Madison, WI 53792-3284
Office: (608) 263-1387
[email protected]
Office: (608) 263-1387
[email protected]
Office: (608) 263-1387
[email protected]
Dr. Chen is the Chair of the Division of General
Surgery at the University of Wisconsin School
of Medicine and Public Health. He is certified by
the American Board of Surgery and specializes
in thyroid disease, hyperparathyroidism, adrenal
tumors and neuroendocrine tumors. Dr. Chen
is an expert in thyroid surgery (thyroidectomy,
neck dissection), parathyroidectomy (minimally
invasive radioguided parathyroidectomy–MIRP),
adrenalectomy (laparoscopic), minimally invasive
endocrine surgery and treatment of carcinoids.
Dr. Schneider is certified by the American Board
of Surgery. He specializes in endocrine surgery,
treating diseases of the thyroid, parathyroid,
and adrenal glands. Dr. Schneider utilizes
several minimally invasive techniques to treat
endocrine disorders (endoscopic thyroidectomy,
parathyroidectomy, adrenalectomy and focused
exploration for recurrent thyroid cancer).
Dr. Sippel is Chief of the Section of Endocrine
Surgery. She is certified by the American Board
of Surgery and specializes in surgical treatment
of the thyroid, parathyroid and adrenal glands.
Dr. Sippel has extensive experience in parathyroid
surgery and treatment of benign and malignant
thyroid disease, such as thyroid cancer, Graves’
disease, hyperthyroidism, thyroid nodules and
goiter and minimally invasive treatment of
adrenal disease.
GS-35322-13