Adrenal Gland Procedures
Many types of adrenal disorders can be successfully treated with adrenal surgery to remove a tumor or an entire adrenal gland.
The adrenal glands are two small organs on top of the kidneys. The glands release hormones that help regulate essential functions such as immune system responses, blood pressure and metabolism.
Adrenal disorders such as Conn's syndrome (hyperaldosteronism), Cushing Syndrome (hypercortisolism), pheochromocytoma (neuroendocrine tumor) or adrenocortical carcinoma (cancer) cause hormonal imbalances that can lead to serious health problems such as diabetes, heart disease or kidney disease. Adrenal disorders are often due to tumors, which are usually benign but sometimes cancerous. Adrenal tumors that secrete hormones, also called functional tumors, are likely to be cancerous.
Types of Adrenal Surgery
- Partial adrenalectomy is removal of the benign tumor, sparing healthy tissue and preserving adrenal gland function. This technique may be used for small benign or cancerous tumors.
- Total adrenalectomy is the removal of one or both adrenal glands. This surgery is necessary for large benign tumors or cancerous tumors of any size.
Adrenal Surgery Approaches
The most appropriate adrenal surgery technique depends on factors that include the type of adrenal disorder causing symptoms, size and location of the tumor, and whether the tumor is benign or cancerous.
- Laparoscopic surgery is a minimally invasive procedure performed using tiny surgical instruments through the smallest possible incisions. An adrenalectomy incision is most often made on the front of the abdomen but is sometimes made on the back.
- Robotic assisted surgery (RAS) is another minimally invasive option. RAS involves performing surgery using a control console, viewing screen and set of robotic arms equipped with special surgical instruments.
- Open surgery involves making a large incision in the abdomen to access the adrenal glands. This technique may be necessary for large cancerous tumors or any tumor that is difficult to reach.
Adrenal Surgery Recovery
The time needed to recover from adrenal surgery primarily depends on the surgical technique. In general, the smaller incisions used in minimally invasive surgery result in less time in the operating room, shorter hospital stays, reduced discomfort after surgery and faster healing.
Adrenalectomy may involve a hospital stay followed by several weeks of restricting activity such as no driving, heavy lifting or vigorous exercise. The recovery process may take anywhere from one week for minimally invasive surgery to six weeks or longer for open surgery.
Life After Adrenal Surgery
Long-term outcomes of adrenal surgery depend on the underlying adrenal disorder, the type of surgery and the health of any remaining adrenal gland tissue.
After surgery, medication may be prescribed to control symptoms as hormone levels stabilize. Cancer treatment options may include radiation therapy, chemotherapy and targeted therapy.
If part or all of one gland is removed, adrenal function may return to normal. If one adrenal gland is removed and the remaining one is not functioning properly, or if both glands are removed, medications and hormone supplements may be needed for a lifetime.
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