Remarkable People. Remarkable Results. department of University of wisconsin school of medicine and public Health

Multidisciplinary Adrenal Care

t UW Health, we offer multidisciplinary adrenal care to meet the needs of patients with adrenal disease. Our team of surgeons works hand-in- A hand 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 or . To make an appointment for an Normally, only one or part of one can produce enough hormones for the body. Often, patients are referred for an after an abdominal adrenal evaluation, please call CT scan reveals an incidental adrenal nodule or an enlarged adrenal gland. (608) 263-7502.

Common conditions include: • Incidental adrenal nodules (revealed by abdominal CT) • • 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.

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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 This minimally invasive approach can be used for patients surgery. UW Health surgeons have successfully treated very having both glands removed and those with extensive large tumors (9–10 cm) laparoscopically. Each case is tailored abdominal scar tissue from previous surgery. to the specific patient and tumor characteristics. What can a patient expect following surgery? What are the benefits of laparoscopic adrenalectomy? Most patients take off up to one week from work and return • Smaller incisions to their normal level of functioning within one to two weeks. • Less pain After surgery, the patient may shower and eat a normal diet. • Less scar tissue Patients are seen in the surgery clinic one to two weeks after • Faster recovery and return to work surgery. Further follow-up with the surgeon or endocrinologist may be needed depending on the specific disorder. Retroperitoneal Adrenalectomy Surgeons may also perform a retroperitoneal adrenalectomy, Are there side effects following adrenalectomy? during which the patient is lying face down and three small If only one of the adrenals is removed, there are usually no incisions are made, measuring less than 0.5 inches. In this side effects or need for hormone replacement. In rare cases position, the adrenal glands lie against the ribcage in the where both adrenal glands are removed, the patient will back and are easily accessible. require hormone replacement.

Herbert Chen, MD David Schneider, MD Rebecca Sippel, MD Professor Assistant Professor of Surgery Associate Professor of Surgery Division of Division of General Surgery Division of General Surgery Clinical Science Center, K3/705 Clinical Science Center, K4/738 Clinical Science Center, K3/704 600 Highland Ave. 600 Highland Ave. 600 Highland Ave. Madison, WI 53792-3284 Madison, WI 53792-3284 Madison, WI 53792-3284 Office: (608) 263-1387 Office: (608) 263-1387 Office: (608) 263-1387 [email protected] [email protected] [email protected] Dr. Chen is the Chair of the Division of General Dr. Schneider is certified by the American Board Dr. Sippel is Chief of the Section of at the University of Wisconsin School of Surgery. He specializes in endocrine surgery, Surgery. She is certified by the American Board of Medicine and Public Health. He is certified by treating diseases of the , parathyroid, of Surgery and specializes in surgical treatment the American Board of Surgery and specializes and adrenal glands. Dr. Schneider utilizes of the thyroid, parathyroid and adrenal glands. in thyroid disease, , adrenal several minimally invasive techniques to treat Dr. Sippel has extensive experience in parathyroid tumors and neuroendocrine tumors. Dr. Chen endocrine disorders (endoscopic , surgery and treatment of benign and malignant is an expert in thyroid surgery (thyroidectomy, , adrenalectomy and focused thyroid disease, such as thyroid , Graves’ neck dissection), parathyroidectomy (minimally exploration for recurrent thyroid cancer). disease, hyperthyroidism, thyroid nodules and invasive radioguided parathyroidectomy–MIRP), goiter and minimally invasive treatment of adrenalectomy (laparoscopic), minimally invasive adrenal disease. endocrine surgery and treatment of carcinoids.

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