An adrenalectomy is surgery to remove your left and/or right adrenal gland when you have a tumor on your adrenal gland that is producing hormones, is suspicious for cancer, large, or growing significantly.

Most patients are candidates for minimally invasive, laparoscopic adrenalectomy (ie, using 3-4 very small incisions and a camera) to remove the affected adrenal gland.

Research has proven that the chance of having a safe and successful adrenal surgery depends on the experience of the surgeon. Dr. Goldfarb is an expert in endocrine and adrenal disorders and high volume adrenal surgeon.

Types of Adrenal Surgery

Your diagnosis as well as the size of your adrenal tumor may impact the type of procedure recommended by your surgeon.

Laparoscopic Transabdominal Adrenalectomy

This is the most common minimally invasive approach utilized by surgeons to remove the adrenal gland. 3-4 small incisions will be made under your rib cage which the surgeon will use to access the adrenal gland by going through the abdominal cavity. Generally, the entire adrenal gland is removed during surgery. This leaves you with one whole, healthy gland on the other side, which will provide all the hormonal control that you need.

Open adrenalectomy

A large abdominal incision is used when there is a diagnosis or a strong suspicion of adrenal cancer before your surgery. Occasionally, other large may also require an open operation. When performed for cancer, en bloc resection of surrounding lymph nodes and any invaded organs is also performed.

Partial Adrenalectomy

In special circumstances, such as patients with bilateral tumors or hereditary syndromes, a partial or cortical-sparing adrenalectomy (where we leave a small part of normal adrenal tissue behind) may be performed. This can be done laparoscopically.

What to Expect the Day of Surgery – Commonly Asked Questions

Laparoscopic surgery usually takes anywhere from one to three hours once you are asleep depending on the type of surgery you are having and the difficulty of the case.

  • Most patients that undergo a laparoscopic adrenalectomy will spend one to two nights in the hospital.
  • Patients that undergo open adrenal surgery will generally spend 3-6 days in the hospital.
  • For patients with functional tumors (ones that make steroids, catecholamines, aldosterone), the length of your stay may depend somewhat on getting you on the right medication for discharge.

The risks of surgery are rare, but exist, and are similar to any abdominal surgery. These include bleeding, infection, injury to nearby blood vessels and structures, possible need for conversion to an open surgery.

After Adrenal Surgery

(For more information please refer to (Adrenalectomy What to Expect)

  • Recovery is usually a few days, mainly due to a generalized fatigue after anesthesia.
  • Most people that undergo a laparoscopic adrenalectomy take off up to a week off from work. Open surgery requires a longer recovery.

  • After unilateral adrenalectomy (most common): If you have one adrenal gland removed there is no need to take supplements. Your other remaining gland will produce all the hormones you need. However, if the adrenal mass you had removed was producing cortisol before surgery (we know this from checking blood tests), then you will likely need to take steroids for a period of time after your surgery. Your physicians will discuss this with you further.
  • After bilateral adrenalectomy: You will need to take adrenal hormone replacement for the remainder of your life. Your physician will discuss this with you further.

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  • If you had surgery because your tumor was functional (meaning that it produced hormones), it is very important to have regular follow-up with endocrinologist and possibly your surgeon to check your blood tests.
  • If you pathology shows an adrenal cancer (very rare), then regular follow-up with your endocrinologist, surgeon, and possibly and oncologist is important.

  • The incisions from laparoscopic surgery are very small and leave very minimal evidence after 6-12 months after surgery.