Adrenalectomy is the removal of one or both adrenal glands. There is one 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.
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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
, Conn’s syndrome, or
pheochromocytomaA large adrenal massAn adrenal mass that cannot be identified with a needle biopsy
Complications may include: 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 problemsAlcoholismUse of certain medicines such as blood pressure pills, muscle relaxants, tranquilizersUse of illegal drugs such as LSD, hallucinogens, marijuana, or cocaine
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 medicines 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, such as: Aspirin
or other anti-inflammatory drugsBlood-thinning medicationsAnti-platelet medication
In the days leading up to your procedure: Arrange for a ride home and 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. These will 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.
approach, the doctor will make 3-4 small incisions in the abdomen. A tiny camera will be passed through one of these openings. To allow a better view, the abdomen will be filled with gas. Other tools will be used to separate the adrenal gland from the kidney. The gland will then be removed through an incision. Stitches or staples will be used to close the incisions. Small bandages will be placed.
A tiny, flexible tube may be placed where the gland was removed. This tube will drain fluids that may build up. It will be removed within one week.
The doctor may need to switch to an
if there are any problems.
You will be monitored in the recovery room.
You will have pain or soreness. Your doctor will give you pain medicine.
You may be nauseated for a few hours after surgery. You may have a tube placed down your nose and into your stomach. This is to drain fluids and stomach acid. You will be able to eat and drink after the tube is removed and you are no longer nauseated.You may be given special compression stockings to decrease the possibility of blood clots forming in your legs.Your body may be making substantially less natural steroid hormones. Your doctor may start you on steroid medications immediately after surgery. The dose will be gradually reduced.
Recovery time may be 7-10 days. To help ensure a smooth recovery: Your doctor will monitor your steroid and hormone levels and make sure that you have the right dose of medicine.Weigh yourself daily. Report to your doctor any weight gain of two or more pounds over 24 hours. This may indicate that you are retaining fluid.Ask your doctor about when it is safe to shower, bathe, or soak in water.Monitor your blood pressure regularly.Increase your physical activity according to your doctor's instructions. This will help you avoid respiratory problems and improve the recovery of your digestive system.
Follow your doctor’s
After you leave the hospital, contact your doctor if any of the following occurs: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision siteNausea and/or vomitingPain that you cannot control with your medicinePain, burning, urgency, or frequency of urination; blood in the urineCough, shortness of breath, or chest painPain and/or swelling in your feet, calves, or legsHeadachesLightheadednessAny new symptom
In case of an emergency, call for medical help right away.
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Gallagher SF, Wahi M, Haines KL, et al. Trends in adrenalectomy rates, indications, and physician volume: A statewide analysis of 1816 adreanlectomies.
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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
Pamaby CN. The role of laparoscopic adrenalectomy for adrenal tumours of 6 cm or greater.
Thompson SK, Hayman AV, Ludlam WH, et al. Improved quality of life after bilateral laparoscopic adrenalectomy for Cushing’s disease: a 10-year experience.
Last reviewed May 2013 by Kim Carmichael, MD; Michael Woods, 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.
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