An adrenalectomy is a surgical procedure performed to remove tumors of the adrenal glands including:
- Benign tumors and cysts
- Malignant primary tumors
- Metastatic tumors that have spread from other organs of the body.
An adrenalectomy is traditionally performed laparoscopically as a minimally invasive procedure through the abdomen, or as an open procedure where a laparoscopic approach not feasible. UCSF also offers appropriately selected patients an approach that uses tiny incisions in the back, one of the few centers in the U.S. to do so.
About the Adrenal Glands
Individuals have two adrenal glands each shaped like a triangle, with one siting atop each kidney. Each gland is comprised of two parts, an outer layer called the adrenal cortex, and the center of the gland, called the adrenal medulla. The adrenal cortex makes important hormones including steroids that balance the water and salt in the body and help maintain normal blood pressure. The adrenal medulla makes catecholamines, the hormones epinephrine (adrenalin), norepinephrine, and dopamine.
Although individuals have two adrenal glands, only one normal gland is needed to provide adequate hormonal function. Where both glands must be removed, patients must take steroid supplements of cortisone and hydrocortisone.
Adrenal Surgery at UCSF
UCSF is a high volume major referral center for endocrine surgery. Most andrenalectomies can be performed laparoscopically through a minimally invasive surgery using tiny incisions and a small scope connected to a video camera. The camera sends a magnified image from inside the body to a monitor, giving the surgeon a close-up view of the adrenal anatomy who operates with miniature surgical instruments that have been passed through the scope.
Laparoscopic adrenalectomy has key advantages for patients including:
- Less post-operative pain and scarring
- Faster recovery and return to normal activities
- A shorter hospital stay
Posterior Retroperitoneoscopic Adrenalectomy (PRA)
UCSF endocrine surgeons now offer a new state-of-the-art surgical procedure, the posterior retroperitoneoscopic adrenalectomy (PRA), to select patients with adrenal tumors and cysts. PRA is a minimally invasive procedure enabling the removal of adrenal masses through small incisions in the back. In addition to the general advantages of minimally invasive laparoscopic surgery discussed above, PRA can further improve patient outcomes by:
- Shortening the time in the operating room
- Reducing blood loss during surgery
- Avoiding abdominal scarring
- Reducing the risk of surgical access site herniation
Importantly, PRA was found to be just as safe as traditional laparoscopic adrenalectomy