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What Is Open Adrenalectomy?

Adrenalectomy is a surgical procedure that removes adrenal glands from the body.Adrenalectomy is a surgical procedure that removes adrenal glands from the body.

Adrenalectomy is a surgical procedure of removing one or both adrenal glands from the body.

The adrenal glands are paired glands located above the kidneys—one on each side. They provide multiple functions in the body such as secreting certain hormones, controlling blood pressure, and helping the body respond to stress.

Adrenalectomy can be performed via either of the two following approaches:

  • Open adrenalectomy: The surgeon performs laparotomy (makes a cut of about 6-12 inch in your abdomen) to remove your adrenal gland. 
  • Laparoscopic adrenalectomy: The adrenal gland is visualized through a laparoscope (a long tube-like camera) after making multiple small cuts in the abdomen and then removed with the help of surgical tools.

Your surgeon will decide the best approach for you, which will depend on the size and location of the excess mass/growth on adrenal glands, the possibility of cancer, and his experience with different techniques.

When do you need adrenalectomy?

Most of the time, your doctor accidentally discovers enlarged adrenal glands or abnormal growth (mass) on adrenal glands. This may be observed on your magnetic resonance imaging (MRI) and computed tomography (CT scan) done for other conditions.

  • Your doctor will plan adrenalectomy on you if
  • Your adrenal mass is greater than 6 cm.
  • He suspects adrenal cancer such as pheochromocytoma.
  • Your adrenal gland is secreting hormones in excess such as in Cushing’s syndrome.

Currently, laparoscopy is a commonly used technique for adrenalectomy. However, open adrenalectomy will be performed in those conditions where laparoscopic adrenalectomy is not possible. These conditions include the following:

  • Obesity
  • Multiple previous abdominal surgeries
  • Large cancerous growth
  • Suspicion of the spread of adrenal cancer to adjacent structures

What is done before open adrenalectomy?

Your doctor can order for computed tomography (CT) or magnetic resonance imaging (MRI) to determine the location and size of the adrenal mass. Routine blood tests will also be done.

Before the surgery, you will be informed regarding the procedure, and your consent will be taken. The following information will be provided to you:

  • Adrenalectomy approach that has been decided
  • Approximate length and location of your incision
  • Risks involved in removing the suspected cancer mass
  • Care that needs to be taken after the surgery
  • Why an ipsilateral nephrectomy (removal of the kidney from the same side) may be required and consent for the same

How is open adrenalectomy performed?

Open adrenalectomy still plays an important role in the armamentarium of adrenal surgeons.

  • The surgery is performed under general anesthesia so that you remain asleep throughout the procedure.
  • A large incision of about 6-12 inch will be made in the upper abdomen or flank just below the ribs.
  • The adrenal gland will be located and delicately separated from its attachments. 
  • Once the adrenal gland has been dissected free, it is then removed through the incision. The entire adrenal gland needs to be excised (cut) to remove the tumor safely.
  • The surgical wound is closed with surgical threads (sutures) and bandaged.

What are the side effects of having an adrenal gland removed?

Removal of adrenal glands may lead to the following side effects:

How long does it take to recover from open adrenalectomy?

Most patients take 5 to 6 weeks to recover from an open adrenalectomy.

  • If there are no complications, you will be discharged from the hospital three to five days after the surgery.
  • You will be prescribed painkillers to help relieve your surgical wound pain.
  • You can resume normal activities after recovery including driving, light lifting, and work, or as advised by your doctor.
  • In case of bilateral adrenal gland removal, your doctor may start you on lifelong medications to compensate for the low hormonal levels of steroids that are secreted by the adrenal glands.

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