Adrenalectomy—Laparoscopic Surgery

by Amy Scholten, MPH

Definition

Adrenalectomy is surgery to remove one or both adrenal glands. These glands are on top of the kidney. They make hormones to help the body to work properly.

Adrenal Glands

Reasons for Procedure

This surgery is done to treat:

Adrenal cancer
Diseases of the adrenal gland, such as Cushing syndrome, Conn syndrome, or pheochromocytoma
A mass in the 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
Infection
Blood clots
Injury to nearby structures
Low levels of cortisol—a hormone that helps the body respond to stress

Things that may raise the risk of problems are:

Smoking
Drinking alcohol
Long term diseases 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

The doctor will give general anesthesia. You will be asleep.

Description of the Procedure

The doctor will make to 3 to 4 small incisions in the abdomen. A tiny camera will be passed through one of these openings. The abdomen will be filled with gas. The gas helps the doctor get a better view. Other tools will separate the adrenal gland from the kidney. The gland will then be removed through an incision. The incisions will be stitched or stapled closed. Small bandages will be placed over them.

A tiny, flexible tube may be placed where the gland was removed. This tube will drain fluids that may build up. It will be removed within 1 week.

The doctor may need to switch to an open surgery if there are any problems.

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 to 3½ hours

Will It Hurt?

Pain and discomfort are common in the first 1 to 2 weeks. Medicine and self-care help.

Average Hospital Stay

2 to 3 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 your healthcare providers to do the same
Reminding staff to wear gloves or masks
Not letting others touch your incision

At Home

It will take about 7 to 10 days to recover. Physical activity will be limited during this time. You will need to delay your return to work.

Call Your Doctor

Call your doctor if you are not getting better or you have:

Signs of infection, such as fever and chills
Redness, swelling, excess bleeding, or any discharge from the incision
Lasting nausea or vomiting
Pain that you cannot control with the medicine
Problems passing urine, or blood in urine
New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

Urology Care Foundation
http://www.urologyhealth.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org

The Kidney Foundation of Canada
https://www.kidney.ca

References:

Adrenal gland removal (adrenalectomy). Society of American Gastrointestinal and Endoscopic Surgeon (SAGES) website. Available at: https://www.sages.org/publications/patient-information/adrenal-gland-removal-adrenalectomy-patient-information-from-sages/. Accessed September 27, 2021.

Adrenocorticotropic hormone measurement. EBSCO DynaMed website. Available at: https://www.dynamed.com/lab-monograph/adrenocorticotropic-hormone-measurement. Accessed September 27, 2021.

Buxton J, Vun SH, et al. Laparoscopic hand-assisted adrenalectomy for tumours larger than 5 cm. Clin Endocrinol (Oxf). 2019;90(1):74-78.

Cushing's syndrome. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed September 27, 2021.

Laparoscopic adrenalectomy. Beth Israel Deaconess Medical Center website. Available at: https://www.bidmc.org/centers-and-departments/urology/urologic-procedures-traditional-and-minimally-invasive/laparoscopic-adrenalectomy. Accessed September 27, 2021.

Laparoscopic adrenalectomy. University of Maryland Medical Center website. Available at: https://www.umms.org/ummc/health-services/surgery/endocrine-surgery/laparoscopic-adrenalectomy. Accessed September 27, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 9/27/2021

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