Adrenalectomy—Open Surgery
Procedure
Definition
Adrenalectomy is surgery to remove one or both adrenal glands. These glands are on top of the kidneys. They make hormones that help the body work properly.
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Reasons for Procedure
This is done to treat:
- Adrenal cancer
- Diseases of the adrenal gland, such as Cushing syndrome, Conn syndrome, or pheochromocytoma
- A mass in an adrenal gland
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Injury to nearby structures
- Low levels of cortisol—a hormone the helps the body respond to stress
Things that may raise the risk of problems are:
- Smoking
- Drinking alcohol
- Long term health issues such as diabetes or obesity
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
An incision will be made under the rib cage or belly. The adrenal gland will then be removed through the incision. The incision will be closed with stitches or staples. A bandage will be placed over the site.
The doctor may place a tiny tube into the area where the gland was removed. The tube will drain fluids that may build up after surgery. It will be taken out within one week after surgery.
Immediately After Procedure
The adrenal gland(s) will be sent to a lab to be checked. You will be sent to a recovery room.
How Long Will It Take?
1½ hours to 3½ hours
Will It Hurt?
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care help.
Average Hospital Stay
4 to 5 days
Postoperative Care
At the Hospital
Right after the procedure, the staff may:
- Give you pain medicines
- Give IV fluids until you are able to eat
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incision
At Home
It will take about 4 to 6 weeks to recover. Physical activity will be limited during this time. You will need to delay your return to work.
You may need to see a doctor who focuses on hormones. They can help you keep hormones in a normal range after surgery.
Problems To Look Out For
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Redness, swelling, excess bleeding, or discharge from the incision
- Nausea or vomiting
- Pain that you cannot control with medicine
- Problems urinating, such as bleeding that does not go away
- New or worsening symptoms
If you think you have an emergency, call for medical help right away.
Urology Care Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Urological Association
The Kidney Foundation of Canada
Urology Care Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Urological Association
The Kidney Foundation of Canada
References
- Aporowicz, M., Domosławski, P., et al. Perioperative complications of adrenalectomy—12 years of experience from a single center/teaching hospital and literature review. Arch Med Sci. 2018; 14 (5): 1010–1019.
- Cushing Disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cushing-disease.
- Laparoscopic and open adrenalectomy. Saint John's Cancer Institute website. Available at: https://saintjohnscancer.org/endocrine/diagnosis-and-treatment/laparoscopic-and-open-adrenaclectomy.
- You and your hormones. Society for Endocrinology website. Available at: https://www.yourhormones.info/glands/adrenal-glands.
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