Adrenalectomy (Adrenal Gland Removal)

What is an adrenalectomy (adrenal gland removal)?

Adrenalectomy is surgery to remove one or both adrenal glands — small glands above each kidney. Your adrenal glands are part of your endocrine system. They affect growth, development, metabolism and sexual function.

You might need an adrenalectomy if you have adrenal cancer in one or both glands or if your glands produce too much of a certain hormone. Adrenal disorders that can cause an overproduction of hormones include hyperaldosteronism, pheochromocytoma and Cushing syndrome.

In many cases, surgeons can do laparoscopic adrenalectomy (which requires one to four small incisions) instead of open surgery (which requires a large incision across your belly). Depending on your specific situation, a surgeon may remove one adrenal gland (unilateral adrenalectomy) or both adrenal glands (bilateral adrenalectomy). They can also remove certain types of adrenal tumors without removing your entire adrenal gland (partial adrenalectomy).

How should I prepare for an adrenalectomy?

You’ll need to make specific preparations leading up to the day of your surgery. You may need additional imaging tests. Or you might need to take medication or follow specific dietary guidelines. Your provider will talk with you before your appointment so you know what to expect.

Because you’ll receive general anesthesia for your procedure, you should arrange for a friend or family member to drive you to and from your surgery.

What happens during an adrenalectomy?

During an adrenalectomy, a surgeon removes part or all of your adrenal gland(s). They can do this in one of three ways:

• Laparoscopic adrenalectomy: A surgeon makes one to four small incisions measuring .25 to .50 inches (0.635 to 1.27 centimeters) in your abdomen. Then, they place tiny surgical instruments through the incisions and remove your adrenal gland(s) with the help of a 2D camera. In most cases, surgeons do adrenalectomies laparoscopically.
• Robotic adrenalectomy: Like laparoscopic surgery, this approach requires one to four small incisions in your abdomen. But instead of doing the surgery by hand, a surgeon uses a computer console and a 3D camera to remove your adrenal gland(s).
• Open adrenalectomy: This traditional approach requires one long incision across your abdomen. A surgeon might choose this method to remove larger tumors measuring over 5.9 inches (15 centimeters) in size or if you have adrenocortical carcinoma.

During a consultation with your healthcare provider, they’ll review these options with you and determine which one is best for your situation.

On average, an adrenalectomy takes about two to three hours to complete.

What happens after my procedure?

If you had a laparoscopic or robotic adrenalectomy, you’ll probably go home the same day as your procedure. If you had open surgery, you might need to stay in the hospital for up to five days. Your provider will help you resume normal routines like eating and drinking. They’ll also help you walk around as soon as possible, to prevent blood clots and other complications.

Your healthcare team will prescribe any necessary medications, schedule a follow-up visit and give you instructions to help you have a successful recovery. In general, you’ll want to:

• Get lots of rest.
• Take all medications as prescribed.
• Drink plenty of water.
• Eat your usual diet if it doesn’t upset your stomach. (If it does, start with bland foods first and work yourself back up.)
• Hold a pillow over your incisions when you cough or take a deep breath.
• Wash and care for your wound(s) as instructed.
• Introduce activity, like walks and work, only when you feel comfortable. (And always check with your provider first.)
• Talk to your provider if you aren’t having regular bowel movements (pooping) without straining.

What are the risks or complications of an adrenalectomy?

As with any surgical procedure, complications may occur. They’re more likely with an open adrenalectomy than with laparoscopic or robotic adrenalectomy.

Possible complications include:

• Bleeding and blood clots.
• Damage to nearby organs.
• Hernia.
• Infection.
• Reactions to anesthesia.
• Problems with wound healing.

What is the recovery time?

In general, adrenalectomy recovery takes one to two weeks. It could be longer if you had open surgery. It’s normal to develop some pain around your incision sites. You can manage this side effect with NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (Advil®) or naproxen sodium (Aleve®).

Everyone gets better at a different pace, but most people recover without complications in two to three weeks. The symptoms you had before your adrenalectomy should go away almost immediately. If your provider removed a cancerous tumor, they’ll monitor you for cancer recurrence (return).

When can I go back to work or school?

Most people can return to work or school within one to two weeks. Be sure to ask your healthcare provider when it’s safe for you to resume routine activities.

When should I call my healthcare provider?

Call your healthcare provider if you:

• Have pain that doesn’t get better with medication.
• See that your stitches are loose or your incision opens.
• Notice signs of infection, such as an incision that feels warm, looks discolored, swells, bleeds, leaks pus or really hurts.
• Develop a fever.
• Don’t poop regularly.

Call 911 or head to your nearest emergency room if you:

• Pass out.
• Have severe trouble breathing.
• Have chest pain or cough up blood.

Can you live a normal life with one adrenal gland?

Yes, your body only needs one healthy adrenal gland to function. If you have both adrenal glands removed, or if your remaining adrenal gland doesn’t work, medications can replace essential hormones. With appropriate management and treatment, people without adrenal glands have a normal life expectancy.