What Happens During Surgery for Adrenal Adenomas?

Surgery for adrenal adenomas is a procedure aimed at removing benign tumors from the adrenal glands. While many adrenal adenomas are non-functioning and may not require surgical intervention, functioning adenomas - tumors that actively secrete hormones - often need to be removed to alleviate the effects of hormone overproduction. Understanding what happens during surgery for adrenal adenomas, as well as the recovery process, can help patients prepare for this important treatment option.

The decision to undergo surgery is made after a thorough evaluation, including imaging tests and bloodwork to assess the nature of the adenoma and its impact on hormone levels. Once surgery is deemed necessary, the patient will undergo a comprehensive preoperative process, followed by the surgery itself, and then postoperative care to ensure a successful recovery.

Preoperative Preparation

Before surgery, the patient will have several appointments to assess overall health and readiness for the procedure. Preoperative preparation typically includes:

Once all of these preoperative steps are complete, the patient is ready for surgery.

Types of Surgery for Adrenal Adenomas

There are two primary surgical approaches for removing adrenal adenomas: laparoscopic adrenalectomy and open adrenalectomy. The choice between these methods depends on factors like the size of the tumor, its location, and whether there are any complications.

1. Laparoscopic Adrenalectomy

Laparoscopic adrenalectomy is the most common surgical technique used to remove adrenal adenomas. This minimally invasive procedure involves making a few small incisions in the abdomen through which a laparoscope - a thin tube with a camera - is inserted. The surgeon uses this camera to view the adrenal gland on a monitor while specialized instruments are used to remove the adenoma.

2. Open Adrenalectomy

In cases where the adenoma is large, potentially cancerous, or difficult to reach, open adrenalectomy may be necessary. This approach involves making a larger incision in the abdomen or back to directly access the adrenal gland. Open surgery is more invasive than laparoscopic surgery but may be required for complex cases.

Postoperative Care and Recovery

Following adrenal surgery, postoperative care focuses on monitoring the patient's hormone levels, managing any discomfort, and ensuring a smooth recovery. Whether the surgery was laparoscopic or open, patients will need to follow a few key steps to ensure a successful recovery:

Risks and Potential Complications

As with any surgery, there are risks associated with adrenal adenoma removal. However, these risks are generally low, particularly for laparoscopic surgery. Some of the potential risks include:

Long-Term Outlook

For most patients, adrenal adenoma surgery leads to a full recovery and a significant improvement in symptoms. Whether the adenoma was causing high blood pressure, weight gain, or hormonal imbalances, removing the tumor typically resolves these issues. Patients who undergo surgery for functioning adenomas often notice an improvement in their quality of life within weeks of the procedure.

In the long term, patients who have had one adrenal gland removed usually do not experience any significant health issues, as the remaining gland can produce enough hormones to meet the body's needs. However, it's important to continue attending regular follow-up appointments and monitoring hormone levels to ensure that the adrenal glands remain healthy.

For those who require hormone replacement therapy after surgery, managing hormone levels with medication can help ensure a healthy, balanced life moving forward.