Adrenalectomy Surgery

Adrenalectomy: Procedure, Diagnosis, and Recovery

What is Adrenalectomy?

Adrenalectomy is a surgical procedure involving the removal of one or both adrenal glands. These small, hormone-producing glands sit above each kidney and are critical to the endocrine system. They influence growth, development, metabolism, and sexual function.

This procedure is performed in cases where:

The adrenal glands are overproducing hormones.
There is a tumor or cancer in the adrenal glands.

Types of Adrenalectomy:

Unilateral Adrenalectomy: Removal of one adrenal gland.
Bilateral Adrenalectomy: Removal of both adrenal glands.
Partial Adrenalectomy: Removal of specific adrenal tumors while preserving the rest of the gland.

Surgeons often prefer laparoscopic adrenalectomy due to its minimal invasiveness, fewer sutures, and faster recovery.

How is It Diagnosed?

Before recommending adrenalectomy, doctors conduct thorough clinical evaluations:

Medical History & Physical Examination: Checks for family history of adrenal or endocrine disorders.
Imaging Studies:
- CT Scan
- MRI
- Adrenal Venous Sampling
Laboratory Tests:
- Blood tests
- Urine tests
- Dexamethasone suppression test
- ACTH stimulation test

How is Adrenalectomy Surgery Done?

1. Laparoscopic Adrenalectomy

Incisions: 1 to 4 small cuts (0.25 to 0.50 inches).
Tools: Miniature instruments and a 2D camera.
Benefits: Less pain, minimal scarring, quicker recovery.
Hospital Stay: Often discharged the next day.

2. Open Adrenalectomy

Incision: Single large cut along the abdomen.
Used For: Tumors larger than 5.9 inches (15 cm) or adrenocortical carcinoma.
Hospital Stay: May require up to 5 days of hospitalization.

3. Robotic Adrenalectomy

Incisions: 1 to 4 small incisions.
Procedure: Surgeon uses a robotic console with a 3D camera to perform the surgery.
Advantages: High precision, improved visualization.

After the Procedure

Laparoscopic/Robotic Surgery: Discharge same day or next day.
Open Surgery: Hospital stay up to five days.
Postoperative Care:
- Resume eating and drinking early.
- Start walking to avoid blood clots.
- Take prescribed medications.
- Attend follow-up appointments.

Frequently Asked Questions

Q: What Would Happen If You Removed Your Adrenal Glands?

A: If only one gland is removed, the other typically compensates. If both glands are removed, lifelong hormone replacement therapy is necessary.

Q: What Worries People the Most Following an Adrenalectomy?

A: Lung complications like pneumonia and atelectasis occur in about 6% of open adrenalectomy cases. Other risks include bleeding, blood clots, and wound infection.

Q: Without Your Adrenal Glands, Is It Possible to Lead a Normal Life?

A: Yes, with proper hormone replacement therapy (e.g., hydrocortisone and fludrocortisone), patients can lead normal lives and often feel better post-surgery.

Q: How Much Time Does It Take to Heal Following an Adrenalectomy?

A: Most people recover in 2 to 3 weeks. Symptoms improve quickly, and if cancerous tumors were removed, follow-up will include cancer recurrence monitoring.