Adrenalectomy

Adrenalectomy is an operation in which one or both adrenal glands are removed. It may be performed for adrenal tumors, hormonally active adrenal disease, suspected cancer, pheochromocytoma, or other selected adrenal conditions. Because the adrenal glands produce important hormones, surgery is not only a technical operation; endocrine evaluation before and after the procedure is often central to safe care. ^[1][2][4][5]

What is adrenalectomy?

The adrenal glands sit above the kidneys and produce hormones involved in blood pressure, metabolism, stress response, and salt balance. Adrenalectomy means removing one adrenal gland or, less commonly, both. The surgery may be done through an open approach or a laparoscopic approach depending on tumor size, location, the likelihood of cancer, and the patient’s anatomy. ^[1][3][6]

Why is it performed?

Adrenalectomy may be recommended for adrenal tumors that secrete excess hormones, for suspicious masses, for adrenocortical cancer, or for conditions such as pheochromocytoma. Not every adrenal lesion requires surgery. Some small, nonfunctioning adrenal incidentalomas are followed rather than removed. The decision depends on imaging features, hormonal testing, symptoms, and cancer risk. ^[2][4][5]

How is the surgery performed?

Many adrenalectomies can be done laparoscopically, especially when the lesion is appropriately sized and there is no strong concern for invasive cancer. In other cases, open surgery may be recommended. During the operation, the gland is carefully separated from surrounding tissues and its blood supply is controlled. If the tumor is hormonally active, preparation before surgery may be especially important to reduce perioperative risk. ^[1][3][5][6]

What can be expected after surgery?

Recovery depends on whether surgery was laparoscopic or open, whether one gland or both were removed, and what hormonal condition was present before surgery. Pain, fatigue, and temporary reduction in activity are common in the early period. Hormone levels may need monitoring after the operation, and some patients require medication support depending on the surgical extent and endocrine findings. ^[1][3][6]

Risks and complications

Possible complications include bleeding, infection, injury to nearby organs, blood pressure instability, hormonal imbalance, and risks related to anesthesia. In hormonally active tumors, perioperative management is especially important because blood pressure and metabolic changes can occur. If both adrenal glands are removed, lifelong hormone replacement becomes a major consideration. ^[1][5][7]

Which symptoms require urgent care?

Fever, increasing abdominal pain, worsening weakness, vomiting, low blood pressure symptoms, wound problems, or signs suggesting adrenal insufficiency require urgent medical attention. Sudden severe weakness, confusion, low blood pressure, vomiting, or collapse may be concerning for adrenal crisis in the appropriate clinical setting. ^[1][7]

Why are pathology results and long-term follow-up important?

The final pathology result may clarify whether the lesion was benign, malignant, or hormonally significant in a way that changes future care. Follow-up may include hormone testing, imaging, oncology review, or endocrine follow-up depending on the diagnosis. In adrenal surgery, treatment does not always end when the operation ends. ^[2][4][5]

What is the difference between one-sided and bilateral surgery?

If only one adrenal gland is removed, the remaining gland can often continue producing the hormones the body needs. If both adrenal glands are removed, lifelong hormone replacement becomes necessary. This difference is one of the most important subjects to discuss before surgery because it has long-term implications for safety, medication, and emergency planning. ^[1][4][7]