Dr. Claire’S
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Bachelor of Medicine and Surgery MBChB (UCT).
Fellow of South African College of Surgeons
Diploma in Obstetrics & Gynaecology
Adrenalectomy
What is an adrenal gland?
Adrenal glands (suprarenal glands) are tiny triangular-like glands located in the upper part of the kidneys. These glands are essential in regulating the functioning of the immune system, blood pressure, metabolism and reaction to stress.
Signs of adrenal gland tumours include:
Hypertension- Low levels of potassium
- Irregular heartbeats (palpitations)
- Anxiety
- Panic attack
- Development of diabetes
- Migraines
Why do I need to have my adrenal glands removed?
Your adrenal glands need to be removed when tumours or growths begin to develop in one or both glands. This is because an adrenal gland tumour may either grow too large (over five centimetres) or secrete excess hormones. When this occurs, Dr Mitchell is required to perform adrenalectomy to dissect one or both adrenal glands. She will advise on which treatment will result in the best possible outcome.
Diagnosis
An ACTH stimulation test is a standard test done to check for adrenal insufficiency. For example, Addison's disease (adrenal insufficiency) occurs when glands secrete minimal cortisol and aldosterone. Too little aldosterone leads to high potassium levels, tiredness and low blood pressure. In contrast, very low amounts of cortisol cause muscle fatigue, changes in mood, darkening of the skin and weight loss.
Tests to diagnose adrenal gland tumours or growths include:
- Blood or urine tests measure adrenal hormones that could indicate the presence of adrenal gland tumours.
- Needle biopsy (core biopsy) is a minor procedure that involves removing a tissue sample from the adrenal gland for observation. It may take several days for the results of the biopsy to come back.
- A metaiodobenzylguanidine (MIBG) scan is a diagnostic test that makes use of a radioisotope and scanner to check for tumours affecting nervous tissue.
- Adrenal vein sampling is considered a gold standard assessment for detecting localised adenomas that secrete aldosterone.
Treatment
Adrenalectomy can be done through minimally-invasive techniques or through open surgery, depending on your condition. Laparoscopic (minimally-invasive) surgery is often carried out to remove adrenal gland tumours through several smaller incisions. Dr Mitchell inserts a surgical instrument (laparoscope) through these cuts to locate and remove the tumour. A laparoscope has a camera attached at the tip that projects images of the operative site to a large monitor in the operating room. These images assist in locating the tumour and prepare for its removal.
Alternatively, Dr Mitchell has the option of performing open surgery to remove an adrenal gland. Larger incisions are created to remove large or malignant adrenal gland tumours.
Alternative therapies include cryoablation, which is effective in freezing and destroying adrenal gland tumours. Using CT scan imaging, a probe delivers a freezing agent (liquid nitrogen/nitrous oxide) that obliterates malignant tissue.
Recovery
Adrenal gland tumour symptoms, including the overproduction of hormones, should dissipate immediately after the adrenalectomy. Depending on the procedure, you can expect the operative site to be sore for a week or two. Usually, the typical recovery time takes about two to three weeks, but this differs in each case. With minimally invasive surgery, you can expect a much faster recovery with less pain.
Please note: The information provided above and on this website is for education and interest purposes only. It is not intended to replace a personal one-on-one consultation, nor is it meant to substitute professional medical advice, diagnose or treat any condition. A consultation with a specialist and qualified health care provider such as Dr Mitchell is essential for correct diagnosis and management, as well as to answer any queries that you may have. Never disregard or delay in seeking professional medical advice due to something you have read on this website. Dr Mitchell takes no responsibility for any errors or omissions present on this website and is not liable for any consequences that may occur from a misinterpretation of the information on this website. In the event of uncertainty or an emergency, please visit your nearest casualty.