Introduction
Adrenalectomy is a surgical procedure that involves the removal of one or both adrenal glands. The adrenal glands are small, triangular-shaped organs located on top of the kidneys. They play a crucial role in producing hormones that regulate various bodily functions, including metabolism, blood pressure, electrolyte balance, and stress response.
The adrenalectomy procedure can either be performed as an open or minimally invasive procedure. Open adrenalectomy involves making a large incision in the abdomen or back to access the adrenal glands. Alternatively, minimally invasive (laparoscopic or robotic) adrenalectomy is performed through several small incisions using specialised surgical instruments and a camera.
Indications
An adrenalectomy is most commonly performed to remove adrenal lesions that are either proven to be or suspected to be malignant, non-functional tumours with the risk of malignancy, and functional adrenal tumours. It may also be necessary to control hormone overproduction, as part of the treatment plan for adrenal cancer, or in rare cases where other tumours have metastasised to the adrenal gland.
Preoperative Instructions
The exact instructions depend on your circumstances and the nature of your surgery. Generally, you will need to fast from the evening before your surgery. You may need to stop taking certain medications prior to the surgery. Dr Moar will advise of specific preoperative instructions.
Procedure
You will be under general anaesthesia for this surgery.
For laparoscopic surgery, Dr Moar will insert a tube via one of four small incisions in the abdomen or flank region. The camera on the end of the tube will guide the surgery.
Open surgery is typically used when the tumours are large, or suspected to be malignant and/or involving nearby structures or other organs.
Dr Moar will carefully identify and isolate the adrenal gland, ensuring that nearby structures, such as blood vessels, are not damaged during the procedure. The affected adrenal gland is then removed from its attachments and taken out of the body through one of the small incisions (in laparoscopic approaches) or the larger incision (in open surgery).
After removing the adrenal gland(s), the surgical incisions are closed with sutures or surgical staples.
Postoperative Instructions
Recovery from adrenalectomy varies depending on the surgical approach and individual factors. Generally, laparoscopic adrenalectomy offers a shorter recovery time and less postoperative pain compared to open adrenalectomy.
Following adrenalectomy, patients may require hormone replacement therapy to manage any hormone imbalances caused by the removal of the adrenal glands. Regular follow-up visits with healthcare providers are essential to monitor hormone levels and overall health.
Risks
It is important to note that while adrenalectomy can effectively treat various adrenal conditions, it is a major surgical procedure with potential risks and complications. Patients should consult with their healthcare providers to assess the potential benefits and risks associated with adrenalectomy in their specific case.
Similar to other surgeries, an adrenalectomy carries the risk of bleeding, infection, and a negative reaction to anaesthesia.
Treatment Alternatives
Medication management can be used as a way to control hormone release for problems associated with hyperfunctioning adrenal glands.
Radiotherapy and chemotherapy can be used to treat adrenal cancer, sometimes in conjunction with each other and surgery.