Definition

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.

Alternative Names

Adrenalectomy; Removal of adrenal glands

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.

Your 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
• Nausea and vomiting

Risks for this surgery include:

• Damage to nearby organs in the body
• Wound that breaks open or bulging tissue through the incision (incisional hernia)
• Hormone changes, where the body may not produce enough hormones after surgery. This includes an 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.
• You are taking any medicines, including drugs, supplements, or herbs you bought without a prescription.

Planning for your surgery:

• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the health care provider who treats you for these conditions.
• If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
• If needed, prepare your home to make it easier to recover after surgery.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

• You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
• Ask your surgeon which medicines you should still take on the day of surgery.
• Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes breakout, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon 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

Most often, 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 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.