adrenalectomy
Meaning of adrenalectomy: Removal of one or both of the small glands capping the kidneys, whose hormones are potent enough that losing both changes life permanently.
Definition of adrenalectomy
An adrenalectomy is an operation to remove one or both adrenal glands, the small hormone-producing glands sitting on top of each kidney. It is performed for tumors of the gland itself and for growths that pour out hormones in excess, and most are now done through several small incisions. Taking one gland usually leaves hormone production intact, because the other compensates.
Why would a gland be removed?
| Reason | What the growth does |
|---|---|
| Pheochromocytoma | Releases adrenaline-type hormones in surges, driving blood pressure up |
| Aldosterone-producing adenoma | Causes high blood pressure alongside a low blood potassium |
| Cortisol-producing adenoma | Produces Cushing syndrome, with weight change, thin skin and high blood sugar |
| Adrenocortical carcinoma | A rare cancer of the gland, frequently hormone-producing as well |
| Deposit spread from elsewhere | A secondary tumor, removed when it is the only site of spread |
Most are taken out by laparoscopic surgery, working through small incisions with a camera, approached either from the front or through the back with the person lying face down. Large tumors and suspected cancers are more often removed through an open incision, since each adrenal gland sits deep against the kidney, the diaphragm and major blood vessels, and its main draining vein is short and awkward to control.
What has to happen before the operation?
Preparation counts for more here than in most surgery, because the gland reacts to being handled. A pheochromocytoma releases its stored hormones when squeezed, which can send blood pressure to dangerous heights during the procedure, so blocking those hormone effects with medication for weeks beforehand is standard practice. Where cortisol has been high for a long time, the opposite gland has fallen dormant and cannot switch back on immediately, so steroid cover is given around the operation. Blood pressure, potassium and blood sugar are watched closely afterward, because the hormone excess ends abruptly rather than tapering.
What changes if both are removed?
Life depends on adrenal hormones, so removing both creates permanent adrenal insufficiency, managed with replacement steroid taken every day thereafter. Illness, injury and surgery raise what the body requires, and someone without adrenal glands cannot produce that increase, which is why the situation carries a standing alert rather than being treated as an ordinary prescription. Taking only one gland avoids all of that in most cases, since the remaining gland enlarges its output within weeks.
Also known as
Used in a sentence
A laparoscopic adrenalectomy was performed for the hormone-producing left adenoma.
Good to know
Removal of both glands produces permanent adrenal insufficiency requiring daily steroid replacement, and a pheochromocytoma is blocked with medication for weeks beforehand because handling the tumor can release a surge of hormone.
Word origin
Where “adrenalectomy” comes from
Adrenal joins the Latin ad, meaning toward, with renes, the kidneys; the ending -ectomy comes from the Greek ektome, a cutting out.