An adrenalectomy is the surgical removal of one or both adrenal glands.
Part of the body's endocrine system, the adrenal glands are located on top of each kidney. The adrenals secrete powerful hormones directly into the bloodstream that regulate sodium and potassium levels, raise the level of sugar in the blood, control some sexual functions and secrete the "flight-or-fight response" hormone adrenaline.
Tumors (hyperaldosteronism, Cushing syndrome, pheochromocytoma) or enlargement of these glands may cause the secretion of an abnormal amount of these hormones and can affect a patient's metabolism. These are usually benign growths, but occasionally may be cancerous. Tumors left untreated can secret abnormal levels of hormones causing a severe imbalance.
Laparoscopic adrenal gland surgery
A laparoscope attached to a video camera is inserted through a small incision in the abdomen just below the rib cage. The view of the procedure is projected onto video monitors in the operating room. The abdomen is inflated with carbon dioxide to allow the surgeon to have a better view of the surgery area.
Two or three smaller incisions are made and other laparoscopic instruments are inserted into the abdomen to remove the adrenal gland. The incisions are closed with sutures and covered with adhesive bandages.
Most patients can expect to stay in the hospital for one day. Recovery time is approximately one to two weeks.
Not all adrenal tumors are suitable for laparoscopic surgery. Patients with very large tumors (more than 10-15 cm), or in whom a primary adrenal cancer is suspected, are not suitable for the laparoscopic procedure and should undergo open surgery. Patients undergoing open adrenalectomy often remain in the hospital for a few days after the operation.
Robot-assisted adrenal gland surgery
Physicians may remove the adrenal glands by using robotically assisted surgery. After removal of one of the adrenal glands, the body produces a normal amount of adrenal hormones. When both glands are removed, patients must take supplemental adrenal hormone replacement medication.