Adrenal Surgery / Adrenalectomy
The adrenal glands are small triangular shaped structures attached to the top of each kidney, located approximately halfway up the back. These glands are important to many of the body’s basic functions as they play a significant role in the secretion of hormones such as cortisone, aldosterone and adrenaline. When one or both adrenal glands begin to malfunction or when a tumor on or in the gland begins to alter its hormonal secretion levels, significant symptoms may result.
Medications prescribed to regulate hormone levels are not curative in that they don’t address the underlying problem. Rather, they alleviate symptoms. Surgery in the form of an adrenalectomy, or removal of the adrenal gland, is often necessary for a permanent solution, especially is medications are causing unacceptable side effects or poor results.
How an Adrenalectomy is Performed
As with most of our other procedures, the primary surgical procedure for a malfunctioning adrenal gland is performed in a minimally invasive manner, meaning that a few small incisions replace the traditional single large incision of open surgery. During the procedure, the affected adrenal gland is carefully separated from the kidney and blood vessels and is removed from the chest cavity using a specially made surgical bag. In all, the procedure takes approximately two to three hours and patients typically remain in hospital for one to two days.
In some cases, especially when an adrenal tumor is cancerous or particularly large, the procedure may have to be converted to open surgery, requiring a single large incision. This is relatively rare.
Considerations of an Adrenalectomy
Adrenal surgery comes with the inherent risks and considerations of any surgical procedure in the abdominal cavity. When the affected adrenal gland is removed from the body, there will be an adjustment period, as the remaining adrenal gland ramps up hormone production to make up for the missing gland. During this time, patients will likely remain on their medication to manage symptoms. However, once the remaining gland produces sufficient hormone levels, patients may be able to eliminate supplemental medication.
It Is also important know that the hormones produced in the adrenal glands may also be secreted elsewhere including, for example, the pituitary gland. Is important that irregular secretions from other structures in the body are ruled out before the adrenal gland is removed. This is done with thorough preoperative testing and collaboration between specialists.
Adrenal tumors can be benign or malignant. In the case of malignancy, it is important that patients are evaluated for the spread of the cancer – known as metastasis. An appropriate surgical and oncological treatment plan will be created based on size and scope of any cancerous tumor. Pathology reports are usually available within a week of surgery.
The first step to understanding the options for treating adrenal related disorders it Is to speak with a qualified general surgeon, such as those at our practice.