Adrenalectomy is the removal of one or both adrenal glands. There is one adrenal gland on top of each kidney. The adrenal glands make several hormones, including cortisol, aldosterone, and sex steroids. The adrenal glands also make adrenaline and noradrenaline in small amounts.
Copyright © Nucleus Medical Media, Inc.
Your adrenal gland may be removed if you have any of the following: Adrenal cancer
Diseases of the adrenal gland, causing it to make too much of a hormone such as
Cushing's syndrome, Conn’s syndrome, and
pheochromocytomaA large adrenal massAn adrenal mass that cannot be identified with a needle biopsy
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Insufficient cortisol productionDecreases in blood pressureBleedingInfections in the wound, urinary tract, or lungsBlood clots in the legsInjury to nearby organs or structuresAdverse reaction to anesthesia
Factors that may increase the risk of complications include: Increased ageObesityLong-standing cortisol excessSmokingPoor nutritionRecent or chronic illnessHeart or lung problems
DrinkingUse of certain medicationsUse of illegal drugs
Your doctor will likely do some or all of the following: Physical examBlood testsUrine tests
Imaging tests, such as
abdominal CT scan,
of the head, and nuclear scan
Give certain medications to determine why the adrenal gland is not working correctly
Let your doctor know which medications you are taking. You may be asked to stop taking or adjust the dose of certain medications.
In the days leading up to your procedure: Arrange for a ride home.Arrange for help at home.The night before, eat a light meal. Do not eat or drink anything after midnight.You may be given laxatives and/or an enema to clean out your intestines.
Your doctors may need to admit you to the hospital before your planned procedure if your blood pressure has not been well-controlled with medication. This will allow more aggressive treatment to stabilize your blood pressure. It will also ensure that you have enough fluid in your body to prevent blood pressure problems after the surgery is done.
You will likely be given IV fluids, antibiotics, and medications that depend on the condition that is being treated.
Large masses are usually removed from the front of your abdomen. This is done so that the mass can be easily removed. The rest of your abdomen can also be examined.
An incision will be made just under your rib cage or in your abdomen. The adrenal gland will be carefully separated from the kidney. The gland will then be removed through the incision. The incision will be closed with either stitches or staples. It will be covered with a sterile dressing.
The doctor may choose to place a tiny, flexible tube into the area where the gland was removed. This tube will drain any fluids that may build up after surgery. It will be removed within one week after your operation.
The adrenal gland(s) will be sent to a lab to be examined. You will be sent to a recovery room. There, you will be monitored for any reactions to the surgery or anesthesia.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The staff will monitor your breathing, pulse, and temperature. You may also need: Pain and anti-nausea medications.A nasogastric tube through your nose and into your stomach. It will drain fluids and stomach acid. You will not be able to eat or drink until this is removed and you are no longer nauseated. In this case, you will continue to receive IV fluids. When you begin eating, you may need to eat a lighter, blander diet than usual.Compression stockings to decrease the possibility of blood clots forming in your legs.Steroid medications immediately after surgery. The dose will be gradually reduced.
Recovery time may be as long as 4-6 weeks. To help ensure a smooth recovery: You will need to be carefully monitored to see that your body is producing the right amount of steroids and hormones. Monitoring also verifies that you are taking the correct dose of steroid or homone replacement medication.You may be asked to weigh yourself daily and report any weight gain of 2 or more pounds over 24 hours. Such weight gain may indicate that you are retaining fluid. You may be asked to monitor your blood pressure regularly at home.Try to increase your physical activity according to your doctor's instructions. This will help you avoid respiratory complications from the general anesthesia and improve the recovery of your digestive system.
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision sitePersistent nausea and/or vomitingPain that you cannot control with the medications you've been givenPain, burning, urgency, or frequency of urinationBlood in the urineCough, shortness of breath, or chest painPain and/or swelling in your feet, calves, or legsHeadachesLightheadednessNew or worsening symptoms
If you think you have an emergency, call for medical help right away.
Agha A, von Breitenbuch P, Gahli N, Piso P, Schlitt HJ. Retroperitonenscopic adrenalectomy: lateral versus dorsal approach.
J Surg Oncol.
Gallagher SF, Wahi M, Haines KL, et al. Trends in adrenalectomy rates, indications, and physician volume: A statewide analysis of 1,816 adreanlectomies.
Hanssen WE, Kuhry E, Casseres YA, de Herder WW, Steyerberg EW, Bonjer HJ. Safety and efficacy of endoscopic retroperitoneal adrenalectomy.
Br J Surg. 2006;93(6):715-719.
Jossart GH, Burpee SE, Gagner M. Surgery of the adrenal glands.
Endocrinol Metab Clin North Am. 2000;29(1):57-68.
Munver R, Del Pizzo JJ, Sosa RE. Adrenal-preserving minimally invasive surgery: The role of laparoscopic partial adrenalectomy, cryosurgery, and radiofrequency ablation of the adrenal gland.
Curr Urol Rep. 2003;4(1):87-92.
Pamaby CN, Chong PS, Chisholm L, Farrow J, Connell JM, O'Dwyer PJ. The role of laparoscopic adrenalectomy for adrenal tumours of 6 cm or greater.
Thompson SK, Hayman AV, Ludlam WH, Deveney CW, Loriaux DL, Sheppard BC. Improved quality of life after bilateral laparoscopic adrenalectomy for Cushing’s disease: A 10-year experience.
Ann Surg. 2007;245(5):790-794.
Last reviewed March 2016 by Donald Buck, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.