What are the adrenal glands?

Adrenal glands are triangular shaped glands on top of your kidneys, typically 4 to 5 cm in size. Adrenal glands produce several hormones such as cortisol, aldosterone, adrenaline and noradrenaline which help control blood pressure, control your body’s response to stress, as well as some of the sex hormones. 

When is adrenal surgery required?

You might require adrenal surgery (adrenalectomy) if the following occurs:

• There is a tumour (may or may not be cancer) of the gland detected incidentally on scans (adrenal incidentaloma).

• There is a cancer of the adrenal gland

• There is overproduction of hormones which causes syndromes such as:

  • Cushing’s Syndrome (excess secretion of cortisol) 

  • Conn’s Syndrome (excess secretion of aldosterone resulting in high blood pressure and blood potassium levels)

  • Phaeochromocytoma (excess secretion of adrenaline and noradrenaline resulting in high blood pressure, excess sweating, tremor, and anxiety)

Hormone-producing adrenal tumours

Some adrenal tumours produce excessive amounts of hormones, even when they are benign. These include phaeochromocytoma, which produces adrenaline-like hormones; Conn’s syndrome, caused by excess aldosterone; and Cushing’s syndrome, caused by excess cortisol.

Careful hormonal testing and medical preparation may be required before surgery. A/Prof. James Lee works with endocrinologists, anaesthetists and other specialists to plan each patient’s treatment safely.

Minimally invasive adrenalectomy

Many adrenal tumours can be removed using minimally invasive - or keyhole - surgery. Small incisions and a camera are used to reach and remove the affected adrenal gland. Compared with open surgery, this approach generally results in less discomfort, a shorter hospital stay and a faster recovery.

The recommended technique depends on the tumour’s size, appearance, location and hormone activity, as well as the patient’s medical history.

Posterior retroperitoneal adrenal surgery

Posterior retroperitoneal adrenalectomy reaches the adrenal gland through small incisions in the back. This provides direct access to the gland without entering the abdominal cavity and may be particularly helpful for suitable patients who have previously undergone abdominal surgery.

Not every adrenal tumour is suitable for this approach. A/Prof. Lee will consider the tumour’s size, location and imaging characteristics before recommending the most appropriate operation.

Open adrenal surgery

Open adrenal surgery uses a larger incision to provide greater access to the adrenal gland and surrounding structures. It may be recommended for very large tumours, suspected adrenal cancer or cases in which nearby organs or blood vessels may be involved.

Although recovery is generally longer than after minimally invasive surgery, an open operation may provide the safest and most appropriate approach for complex adrenal disease.

Recovery after adrenalectomy

Patients who undergo minimally invasive adrenal surgery can usually begin eating, drinking and walking soon after their procedure. Many leave hospital the following day, although the length of stay and recovery time vary between patients and procedures. Recovery after open surgery generally takes longer.

Some patients require temporary or ongoing hormone medication after adrenalectomy. You will receive individual instructions about pain relief, wound care, activity, medications and follow-up before leaving hospital. See our After Surgery guide for more detailed recovery information.

Why choose A/Prof James Lee for adrenal surgery?

A/Prof James Lee is a specialist endocrine surgeon with more than 15 years’ experience in managing patients with adrenal tumours. His adrenal practice includes the surgical management of hormone-producing tumours, adrenal incidentalomas and suspected adrenal cancers, using minimally invasive or open abdominal approaches where appropriate.

His clinical practice is supported by academic research, peer-reviewed publications and multidisciplinary collaboration with endocrinologists, radiologists and anaesthetists. The choice of whether to operate - and which surgical approach to use - is individualised according to each patient’s diagnosis, imaging, hormone results and overall health.

Adrenal surgery with A/Prof. James Lee

If you require any type of adrenal surgery, A/Prof. James Lee ensures to provide his patients with the most education and communication possible throughout the course of the journey. If you have any questions or concerns regarding adrenal surgery, please do not hesitate to get in touch with our team.

Disclaimer

The information provided here is intended for general reference and education only.
Always consult with A/Prof. Lee about your individual situation.
A/Prof. Lee cannot be held liable for any deviations from the details provided in this guide.