Adrenal Gland Surgery (Adrenalectomy)


Anatomy and adrenal gland surgery

The adrenal glands are small triangles-shaped glands located above each kidney. They are part of the endocrine system and produce hormones. The outer portion of the adrenal gland produces steroid hormones such as cortisol, aldosterone and testosterone. The inner portion produces epinephrine and nor epinephrine. The hormones produced by these glands are important in controlling blood pressure, our bodies’ chemical balance, glucose, and your “fight or flight” reaction.

Adrenal gland symptoms

Adrenal gland problems usually occur when a mass or tumor forms on the gland. Most masses are benign and not cancerous. Sometimes a mass in the adrenal gland is removed because it releases a hormone that can cause harmful side effects.

Patients with adrenal gland problems may have a variety of symptoms related to excess hormone production.

  • Aldosterone producing tumors cause high blood pressure and low potassium levels. This sometimes causes weakness, fatigue, and frequent urination.
  • Cushing’s syndrome is too much cortisol. Usual symptoms are: obesity, high blood sugar, high blood pressure, menstrual irregularities,and fragile skin.
  • Pheochromocytomas produce excess hormones that can cause very high blood pressure, headaches, excessive sweating, anxiety, palpitations, and rapid heart rate off and on.

Adrenal gland surgery

Your adrenal gland surgery may be performed either laparoscopic or via the traditional open surgery method. It may be necessary to convert a laparoscopic procedure to an open method during the procedure if conditions warrant. Prior to surgery, your surgeon will discuss with you your options so you can decide on the best course of treatment.

Adrenal gland surgery is conducted as follows:

  • The surgery is performed under a complete general anesthesia, so that the patient is asleep during the procedure and feels no pain.
  • For laparoscopic surgery, a laparoscope is connected to a special TV camera. This gives the surgeon a magnified view of the adrenal gland.
  • It is almost always necessary to remove the entire adrenal gland in order to safely remove the tumor.
  • After the surgeon removes the adrenal gland, the incisions are closed.

Preparing for adrenal gland surgery

Prior to surgery, your surgeon will review with the risks and benefits of the operation which may include but are not limited to:

  • Blood clots in the legs that may travel to the lungs
  • Breathing problems
  • Damage to nearby organs in the body
  • Heart attack or stroke
  • Infection or bleeding
  • Reactions to medicines
  • Wound that breaks open or bulging tissue through the incision (incisional hernia)
  • Need for blood transfusions
  • Your doctor will tell you which of your normal medications and any additional medications, including over the counter medications, you may continue to take prior to surgery.
  • Before your surgery after midnight, you should not eat or drink anything except any medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
  • Smokers are advised to stop smoking as it may increase the risk of complications associated with surgical intervention and also contributes to long-term health problems such as, risk of cardiovascular disease, peripheral vascular disease and neurologic disease.
  • Hospital discharge planning staff and your doctor will decide if you will need help when you return home.

After adrenal gland surgery

  • Many people feel better in just a few days.
  • After laparoscopic adrenal gland removal, most patients can be cared for on a regular surgical nursing unit. Most patients can be discharged from the hospital within one or two days after surgery.
  • If your blood pressure needs to be watched, you may stay in the intensive care unit.
  • Patients can remove any dressings and shower the day after the operation.
  • Patients are encouraged to engage in light activity while at home after surgery.
  • After surgery pain is usually mild, but may require pain medication.
  • Most patients can resume normal activities within one week.
  • A follow up visit will be made with your surgeon in 2 weeks.