Adrenalectomy

Answer 1

Definition

Adrenalectomy is an operation in which one or both adrenal glands are removed. The adrenal glands are part of the endocrine system and are located just above the kidneys.

Alternative Names

Adrenal gland removal; Removal of adrenal glands

Description

Adrenalectomy can be performed in two ways. In the "open" surgery, the surgeon makes one large surgical cut to remove the gland. With the "laparoscopic" technique, several small incisions are made. The surgeon will discuss which approach is better for you.

For the surgery, you will be placed under general anesthesia(unconscious and pain-free).

The adrenal gland is sent to a pathologist for examination under a microscope.

Indications

The adrenal gland is removed when there is known cancer or a growth (mass) that might be cancer.

Sometimes a mass in the adrenal gland is removed because it releases a hormone that can cause harmful side effects. One of the most common tumors is a pheochromocytoma. This tumor can cause very high blood pressure.

Risks

With any operation or anesthesia, there is a slight risk of:

• 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)

Expectations after surgery

It is important to have the procedure done at a center that is experienced in adrenal gland removal.

Before You Have the Procedure

Your surgeon will give you instructions about your diet, including when you should stop eating and drinking. Be sure to have a complete list of your medications so that your surgeon and anesthesiologist can give you instructions about them.

Convalescence

As with any operation, there will be discomfort after surgery.

• Your health care provider will prescribe pain medications.
• You may need stool softeners to avoid constipation.
• Your surgeon will give you instructions about restricting your activities.

Complete recovery from the procedure may take several weeks or longer, depending on the type of surgical cuts you have.

References

Young WF Jr. Adrenal medulla, catecholamines, and pheochromocytoma. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 246.

Answer 2

Definition

Adrenalectomy is an operation in which one or both adrenal glands are removed. The adrenal glands are part of the endocrine system and are located just above the kidneys.

Alternative Names

Adrenal gland removal; Removal of adrenal glands

Description

Adrenalectomy can be performed in two ways. The type of surgery you will undergo depends on the problem being treated.

• In the "open" surgery, the surgeon makes one large surgical cut to remove the gland.
• With the "laparoscopic" technique, several small cuts are made.

The surgeon will discuss which approach is better for you.

For the surgery, you will be placed under general anesthesia (asleep and pain-free).

After the adrenal gland is removed, it is always sent to a pathologist for examination under a microscope.

Indications

The adrenal gland is removed when there is known cancer or a growth (mass) that might be cancer.

Sometimes a mass in the adrenal gland is removed because it releases a hormone that can cause harmful side effects.

• One of the most common tumors is a pheochromocytoma, which can cause very high blood pressure
• Other disorders include Cushing syndrome, Conn syndrome, and an adrenal mass of unknown cause

Risks

With any operation or anesthesia, there is a slight risk of:

• 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)

Expectations after surgery

It is important to have the procedure done at a center that is experienced in adrenal gland removal.

Before You Have the Procedure

Always tell your doctor or nurse:

• If you could be pregnant
• What drugs you are taking, even drugs or herbs you bought without a prescription

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), and other drugs like these.
• Ask your doctor which drugs you should still take on the day of the surgery.
• Do not smoke. This will help you recover more quickly.

On the day of the surgery:

• Your doctor or nurse will tell you what you can drink or eat the night before and the day of the surgery.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

Convalescence

As with any operation, there will be discomfort after surgery.

• Your health care provider will prescribe pain medications.
• You may need stool softeners to avoid constipation.
• Your surgeon will give you instructions about restricting your activities.

Most patients who undergo laparoscopic adrenalectomy have a shorter hospital stay, less pain, and faster recovery compared to the open procedure.

Complete recovery from the procedure may take several weeks or longer, depending on the type of surgical cuts you have.

References

Duh QY, Yeh MW. The adrenal glands. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 39.

Reviewed By

Review Date: 01/26/2011

Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.