OVERVIEW

Adrenal gland surgery, also labelled “adrenalectomy", is surgery to remove the adrenal gland(s) when the gland(s) produces hormones in excess or turns cancerous. This procedure can be done through open or minimally invasive techniques. The aim of adrenalectomy is to eliminate or manage the underlying pathology and restore normal adrenal gland function.

Adrenalectomy is indicated in the following situations:

• Adrenal Tumors: If a tumour is detected in one or both adrenal glands, surgical removal may be recommended to determine whether the tumour is benign or malignant. Adrenalectomy may also be performed to remove an adrenal tumour that is causing symptoms or compromising the function of nearby organs.
• Hormonal Imbalances: Conditions such as Cushing's syndrome (excessive cortisol production), Conn's syndrome (excessive aldosterone production), and pheochromocytoma (adrenal medulla tumour causing excessive catecholamine secretion) may require adrenalectomy to restore hormonal balance and alleviate associated symptoms.
• Adrenal Hyperplasia: Adrenalectomy can be considered for patients with adrenal hyperplasia, a condition characterised by excessive growth and activity of the adrenal glands. This procedure helps manage hormonal imbalances and their related complications.
• Suspected Adrenal Malignancy: In cases where a tumour is suspected to be malignant based on imaging studies or biopsy, adrenalectomy may be performed to remove the affected gland and potentially prevent the spread of cancer.

ADRENALECTOMY PROCEDURE

Adrenalectomy can be performed using different surgical approaches, depending on the underlying condition, tumour size, and surgeon's expertise. The two primary methods are:

• Laparoscopic Adrenalectomy: This minimally invasive technique involves making several small incisions in the abdomen. A laparoscope (a thin, flexible tube with a camera) and specialised surgical instruments are inserted through these incisions. The surgeon views the operative field on a monitor and carefully removes the adrenal gland(s) using the instruments. Laparoscopic adrenalectomy offers advantages such as shorter hospital stays, reduced post-operative pain, and faster recovery compared to open surgery.
• Open Adrenalectomy: In certain cases, an open surgical approach may be required. This involves making a larger incision in the abdomen or flank region to access the adrenal gland(s). Open adrenalectomy may be necessary for larger tumours, complex cases, or if laparoscopic surgery is contraindicated. The surgeon carefully removes the affected adrenal gland(s) and ensures hemostasis before closing the incision.

Both laparoscopic and open adrenalectomy procedures are performed under general anaesthesia. The specific approach chosen depends on the patient's condition, the surgeon's expertise, and the overall surgical plan.