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Adrenal gland removal

Adrenalectomy; Removal of adrenal glands

Adrenal gland removal 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.

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Description

You will receive general anesthesia that allows you to be asleep and pain free during surgery.

Adrenal gland removal can be performed in two ways. The type of surgery you have depends on the problem being treated.

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

The surgeon will discuss which approach is better for you.

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

Why the Procedure Is Performed

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

Risks for anesthesia and surgery in general include:

• Reaction to medicines
• Breathing problems
• Bleeding, blood clots, or infection

Risks for this surgery include:

• Damage to nearby organs in the body
• Wound that breaks open or bulging tissue through the incision (incisional hernia)
• Acute adrenal crisis in which there is not enough cortisol, a hormone produced by the adrenal glands

Before the Procedure

Tell your surgeon or nurse:

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

During the days before surgery:

• You may be asked to temporarily stop taking blood thinners. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin, Jantoven), and others.
• Ask your surgeon which medicines you should still take on the day of the surgery.

If you smoke, try to stop. Smoking slows recovery and increases the risk for problems. Ask your health care provider for help quitting.

On the day of surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your doctor told you to take with a small sip of water.
• Arrive at the hospital on time.

After the Procedure

While in the hospital, you may:

• Be asked to sit on the side of the bed and walk on the same day of your surgery
• Have a tube, or catheter, that comes from your bladder
• Have a drain that comes out through your surgical cut
• Not be able to eat the first 1 to 3 days, and then you will begin with liquids
• Be encouraged to do breathing exercises
• Wear special stockings to prevent blood clots
• Receive shots under your skin to prevent blood clots
• Receive pain medicine
• Have your blood pressure monitored and continue to receive blood pressure medicine

You will be discharged in 1 or 2 days after the surgery.

At home:

• Follow instructions on how to care for yourself as you recover.
• You can remove the dressing and shower the day after the surgery, unless your surgeon tells you otherwise.
• You may have some pain and may need to take medicine for pain.
• You can start doing some light activities.

Recovering from open surgery may be painful because of where the surgical cut is located. Recovery after a laparoscopic procedure is most often quicker.

Outlook (Prognosis)

People who undergo the laparoscopic surgery mostly have faster recovery than with open surgery. How well you do after surgery depends on the reason for the surgery:

• If you had surgery for Conn syndrome, you may have to stay on blood pressure medicines.
• If you had surgery for Cushing syndrome, you are at risk for complications that may need to be treated. Your provider can tell you more about this.
• If you had surgery for pheochromocytoma, the outcome is usually good.

References

Lim SK, Rha KH. Surgery of the adrenal glands. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 107.

Miller BS, Doherty GM. Adrenal surgery. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 100.

Yeh MW, Livhits MJ, Duh QY. The adrenal glands. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 40.

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Review Date: 3/11/2023  

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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