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Adrenalectomy

Adrenalectomy is the removal of one or both adrenal glands. There is one gland on top of each kidney. The adrenal glands make several hormones, including cortisol, aldosterone and sex steroids. The adrenal glands also make adrenaline and noradrenaline in small amounts.

Your adrenal gland may be removed if you have any of the following:

  • Adrenal cancer

  • Diseases of the adrenal gland, causing it to make too much of a hormone such as Cushing's syndrome, Conn's syndrome or pheochromocytoma

  • A large adrenal mass

  • In certain cases, the spread of cancer to the adrenal gland from another site

Possible Complications  

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Insufficient cortisol production

  • Decreases in blood pressure

  • Bleeding

  • Infections in the wound, urinary tract or lungs

  • Blood clots in the legs

  • Injury to nearby organs or structures

  • Adverse reaction to anesthesia

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking

  • Drinking

  • Chronic diseases, such as diabetes or obesity

  • Long-standing cortisol excess

  • Smoking

  • Poor nutrition

  • Recent or chronic illness

  • Heart or lung problems

  • Drinking

  • Use of certain medications

  • Use of illegal drugs 

Preparing for Your Adrenalectomy

Your doctor will likely do some or all of the following:

  • Physical exam

  • Blood tests

  • Urine tests

  • Imaging tests, such as abdominal ultrasoundabdominal CT scanMRI scan, CT scan of the head and nuclear scan

  • Give certain medications to determine why the adrenal gland is not working correctly

Let your doctor know which medications you are taking. You may be asked to stop taking or adjust the dose of certain medications.

Before the procedure:

  • Arrange for a ride home

  • Arrange for help at home

  • The night before, eat a light meal

  • Do not eat or drink anything after midnight

The Blood Pressure Factor

Your doctors may need to admit you to the hospital before your planned procedure if your blood pressure has not been well controlled with medication. This will allow more aggressive treatment to stabilize your blood pressure. It will also ensure that you have enough fluid in your body to prevent blood pressure problems after the surgery is done.

The Adrenalectomy Procedure    

You will likely be given IV fluids, antibiotics and medications that depend on the condition that is being treated.

General anesthesia will be used. You will be asleep during the procedure.

With the laparoscopic approach, the doctor will make 3-4 small incisions in the abdomen or back. A tiny camera will be passed through one of these openings. To allow a better view, the abdomen will be filled with gas. Other tools will be used to separate the adrenal gland from the kidney. The gland will then be removed through an incision. Stitches or staples will be used to close the incisions. Small bandages or glue dressing will be placed.

The doctor may need to switch to an open adrenal removal surgery if there are any problems.

Recovering from an Adrenalectomy

At the Hospital

We will monitor you in the recovery room for one-three hours. You will stay in the hospital for one to three days.

The staff will monitor your breathing, pulse and temperature. You may also need:

  • Pain and anti-nausea medications

  • Compression stockings to decrease the possibility of blood clots forming in your legs

  • Steroid medications immediately after surgery.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

  • Washing their hands

  • Wearing gloves or masks

  • Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

  • Washing your hands often and reminding your healthcare providers to do the same

  • Reminding your healthcare providers to wear gloves or masks

  • Not allowing others to touch your incision

At Home

Recovery time may be 7-10 days. To help ensure a smooth recovery:

  • Your doctor will monitor your steroid and hormone levels and make sure that you have the right dose of medication.

  • Weigh yourself daily. Report to your doctor any weight gain of two or more pounds over 24 hours. This may indicate that you are retaining fluid.

  • Monitor your blood pressure regularly.

  • Increase your physical activity according to your doctor's instructions. This will help you avoid respiratory problems and improve the recovery of your digestive system.

Signs of a Problem  

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills

  • Redness, swelling, increasing pain, excessive bleeding or any discharge from the incision site

  • Persistent nausea and/or vomiting

  • Pain that you cannot control with the medications you've been given

  • Pain, burning, urgency or frequency of urination

  • Blood in the urine

  • Cough, shortness of breath or chest pain

  • Pain and/or swelling in your feet, calves or legs

  • Headaches

  • Lightheadedness

  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

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Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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