The adrenal glands are golden-yellow triangle or crescent shaped glands which are attached to the top of each of your two kidneys. They are normally about 3 x 5 x 1 cm in size. Each gland had a cortex which surrounds the medulla. Each region of the gland is responsible for hormone production such as cortisol and aldosterone in the cortex and norepinephrine and epinephrine (adrenaline) in the medulla. The adrenal gland also manufactures some of the sex hormones.

Surgical removal of the adrenal gland (adrenalectomy) may be recommended in situations of hormone overproduction or if there is a concern that a mass of the adrenal gland may be a cancer.

Three main situations exist where hormone overproduction is an indication to have an adrenalectomy. The first is Cushing's Syndrome in which excess steroid production (cortisol) is caused by a tumor of the adrenal cortex. The second is Conn's Syndrome in which a tumor of the same area produces excess aldosterone which may cause problems with high blood pressure and blood potassium levels. The third is a tumor of the medulla which is called a pheochromocytoma. This tumor may manufacture excess adrenaline and cause problems such as high blood pressure, excess sweating, tremor, and anxiety.

Sometimes an adrenal tumor is found incidentally during an ultrasound or CAT scan of the abdomen. Even if these tumors do not overproduce hormones and cause any of the problems above, adrenalectomy may be recommended due to the size or other characteristics of the mass. This is because of concern that the mass may be a cancer of the adrenal gland. Adrenal cancer is very rare, but adrenalectomy may be the only chance to cure the cancer. If the tumor is a cancer that has spread from another organ to the adrenal gland, that is not a good reason for adrenalectomy (with very few exceptions).

Adrenalectomy may be performed in two main fashions - an open procedure or a laparoscopic procedure. Open operations may be performed through the back (sometimes requiring partial removal of a rib), the flank, or the abdomen. Laparoscopic procedures use small telescopes and long instruments to remove the adrenal gland through a series of small incisions. Typically, patients having laparoscopic procedures have less pain and a more rapid recovery.

The method by which the adrenalectomy is performed depends on many factors including the specific disorder, tumor size, and general patient health. Laparoscopic adrenalectomy is not an appropriate operation if there is strong evidence that the tumor is an adrenal cancer.

We have included a short video (1.4 mg / .mpg file) of an adrenalectomy for you to view. You may click here to begin.