Adrenal Gland Removal

Overview

The adrenal glands are small organs located just above each kidney. Each gland is approximately the size of a walnut and triangular in shape. The adrenal glands produce hormones that control many bodily functions such as, blood pressure, electrolytes, and the “fight or flight” reaction to stress. Some of the hormones produced by the adrenal gland include aldosterone, cortisol, epinephrine, and norepinephrine. Diseases of the adrenal gland include adrenal masses or adrenal tumors that secrete excess hormones. An aldosteronoma and pheochromocytoma are examples of adrenal tumors. Adrenal masses that produce excess cortisol result in a condition called Cushing's syndrome. Some adrenal masses or tumors are non-functional (do not secrete hormones) and are found on x-rays obtained to evaluate another problem.

Procedure

An adrenalectomy or removal of the adrenal gland can be performed laparoscopically. A laparoscopic adrenalectomy is performed through 4 small incisions (all < 1 inch) instead of a large incision or the “open” approach which may require a large 10-12 inch incision. A laparoscope and long thin instruments are used to perform the operation. The laparoscope functions as a camera to visualize and magnify the abdominal contents to monitors outside of the body. The adrenal gland is dissected away from the kidney and the arteries and vein are clipped and divided.

Advantages of the Procedure

The advantages of a laparoscopic adrenalectomy include a smaller incision, less pain, a shorter hospital stay, a faster recovery, less wound complications, and a lower chance of future hernias.

Recovery

The majority of patients return home the day after surgery. Most patients return to work in approximately one week depending on the physical requirements of their occupation. Patients return two weeks after surgery for routine follow-up with their surgeon.

Publications

Rosen M, Gill I, Brody FJ. Metastatic melanoma to the adrenal glands: case report and literature review. Surg Rounds July: 359-364, 2001.

Farres H, Felsher J, Brodsky J, Siperstein A, Gill I, Brody FJ. Laparoscopic adrenalectomy A case analysis of three approaches. J Laparoendosc Adv Surg Tech 14(1): 23-6, 2003.

Kar R, Brody F, Pucci E. Laparoscopic resection of an adrenal pseudocyst. J Laparoendosc Adv Surg Tech 16(5): 478-481, 2006.

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