Adrenalectomy

Overview

Adrenalectomy is surgery to remove one or, rarely, both adrenal glands — the small, hormone-producing glands that sit on top of each kidney. The adrenal glands make hormones that regulate blood pressure, salt and water balance, metabolism, and the body's response to stress. Surgery is performed when a gland develops a tumour, over-produces a hormone, or is enlarged in a way that causes symptoms or raises concern about cancer.

Many adrenalectomies are done by minimally invasive (keyhole or robotic) surgery through small incisions, though larger or complex tumours may need open surgery. Because the adrenal glands control powerful hormones, care is shared with endocrinologists and anaesthetists before, during, and after the operation.

This page is an educational overview only. It is not medical advice, and no outcome can be guaranteed. This is specialised surgery that requires an experienced team.

Who May Need This

Adrenalectomy may be considered for people with an adrenal tumour that is large, growing, or suspicious for cancer, or a tumour that over-produces hormones. Hormone-producing tumours include those causing high blood pressure and dangerous surges (phaeochromocytoma), excess cortisol (Cushing's syndrome), or excess aldosterone (Conn's syndrome, causing high blood pressure and low potassium).

It may also be recommended for adrenal masses found incidentally on scans that meet criteria for removal, or for cancer that has spread to the adrenal gland in selected cases. Eligibility is determined by an endocrine and surgical team after hormone testing and imaging.

When It May Be Recommended

Surgery may be recommended when an adrenal tumour produces excess hormones that cannot be controlled with medication alone, when a mass is large or has worrying features on imaging, or when it is growing over time. It is also recommended for confirmed or strongly suspected adrenal cancer.

The decision weighs the benefits of removing the tumour and correcting hormone problems against the risks of surgery and anaesthesia, particularly for hormone-active tumours that require careful preparation. The final recommendation depends on individual evaluation by the specialist team.

Diagnosis and Evaluation

Evaluation includes detailed hormone (biochemical) testing of blood and urine to determine whether and which hormones a tumour is producing, and imaging such as CT or MRI to assess the size, features, and location of the mass. Specialised scans may be used for certain tumours.

General health, heart and lung fitness, and blood pressure are assessed, and an endocrinologist plans any medication needed before surgery. For hormone-active tumours, careful preparation is essential. Because decisions are complex, a second opinion at a specialist centre can be valuable.

Treatment Options

Treatment depends on the type of tumour and hormone problem. Some conditions can be managed with medication — for example, drugs that block excess hormone effects — while others require surgery to remove the source. Small, non-functioning, benign-appearing masses may simply be monitored with repeat imaging and testing.

When surgery is chosen, options include minimally invasive adrenalectomy (laparoscopic or robotic) for most benign tumours, and open adrenalectomy for large tumours or suspected cancer. The surgeon and endocrinologist recommend the approach that best fits the diagnosis.

How It Is Performed

Adrenalectomy is performed under general anaesthesia. In minimally invasive surgery, the surgeon makes several small incisions and uses a camera and long instruments (or a robotic system) to carefully separate the adrenal gland from surrounding structures, control its blood vessels, and remove it, usually in a retrieval bag. Open surgery uses a larger incision for direct access.

For hormone-active tumours, the anaesthetist manages blood pressure closely during the operation. Surgery commonly takes one to several hours depending on complexity. A hospital stay of a day or two is typical after keyhole surgery, and longer after open surgery.

Preparation

Preparation is thorough and tailored to the tumour type. For hormone-active tumours, specific medication is often given for days to weeks beforehand to control blood pressure and make surgery safer, coordinated by an endocrinologist. General pre-anaesthetic checks, blood tests, and imaging review are completed, and medications are adjusted as advised.

You must follow fasting instructions before anaesthesia. If considering treatment abroad, gather all hormone results, imaging, and records, and plan for an appropriately long stay and careful follow-up, since hormone management continues after surgery.

Benefits and Expected Goals

The goals of adrenalectomy are to remove a tumour and, where relevant, correct hormone over-production that causes high blood pressure, metabolic problems, or other symptoms. Many appropriately selected patients have improved or normalised blood pressure and hormone levels after surgery, and removal of a suspicious mass reduces the risk it poses.

Benefits vary by individual and by the underlying condition. Some effects of long-standing hormone excess improve gradually, and some patients still need medication or monitoring. The team can discuss realistic goals and what to expect in your case.

Risks and Possible Complications

Adrenalectomy is generally safe in experienced hands, but it is significant surgery near major blood vessels and organs, with real risks.

• Bleeding, sometimes requiring transfusion or conversion to open surgery
• Injury to nearby organs such as the kidney, spleen, liver, pancreas, or bowel
• Large swings in blood pressure during surgery, especially with hormone-active tumours
• Infection or wound problems
• Hormone deficiency needing replacement, particularly if both glands are affected or the other gland is suppressed
• Blood clots and risks related to general anaesthesia

Your team will explain the risks specific to your tumour and health and how complications would be managed. Hormone monitoring after surgery is important.

Recovery, Follow-up & Aftercare

Recovery varies by approach and individual. After keyhole surgery, many people are up and moving within a day, go home in a day or two, and return to normal activities over two to four weeks. Open surgery involves a longer recovery. Pain is managed, and activity is increased gradually as advised.

Follow-up includes hormone monitoring, blood pressure checks, and, for some patients, temporary or ongoing hormone replacement, especially after removal for cortisol excess. Review of the pathology guides any further treatment. If treated abroad, arrange clear endocrine follow-up with your doctors at home before returning.

Medical Tourism Planning

Adrenalectomy should be undertaken only at a JCI- or ISO-accredited hospital with endocrine surgery expertise, endocrinology support, and intensive care. Confirm the team's experience with adrenal surgery and hormone-active tumours, and request a detailed written treatment plan and cost estimate before travelling.

Plan for an in-country stay covering preparation, surgery, and initial recovery, and for a clear handover of hormone monitoring and follow-up to your doctors at home. Consider comprehensive medical travel insurance.

Estimated Cost Factors

The cost of adrenalectomy depends on the country and hospital, the surgical approach (laparoscopic, robotic, or open), the complexity and type of tumour, hormone work-up and preparation, intensive care and length of stay, and pathology charges. Hormone-active tumours generally require more extensive care.

Many international destinations offer complex surgery at a fraction of typical prices in higher-cost countries, but figures vary widely by case. Online prices are only estimates — always request a personalized written quote and treatment plan before deciding.

Choosing a Hospital or Specialist

Choose a hospital with recognised accreditation and a dedicated endocrine surgery programme, with experienced surgeons, endocrinologists, and anaesthetists familiar with adrenal tumours. Confirm case volume with adrenalectomy and the availability of minimally invasive options.

Ask about intensive care, management of blood-pressure swings during surgery, international patient services, and how hormone follow-up will continue after you return home. A coordinated, multidisciplinary team is essential for this surgery.

Alternatives

Depending on the diagnosis, alternatives to surgery may include active monitoring with repeat imaging and hormone testing for small, non-functioning, benign-appearing masses, and medication to control hormone over-production in some conditions. For cancer that has spread, other cancer treatments may be part of the plan.

Each option has different benefits and risks, and some hormone problems ultimately require surgery for lasting control. Discuss the alternatives thoroughly with your endocrine and surgical team, and consider a second opinion for complex decisions.

Questions to Ask Your Doctor

• What type of adrenal tumour do I have, and is it producing hormones?
• Can it be removed by keyhole surgery, or is open surgery needed?
• What preparation will I need to make the operation safe?
• What are the specific risks in my case, and might I need hormone replacement?
• What follow-up and hormone monitoring will I need, and for how long?
• If treated abroad, how will my endocrine follow-up continue at home?
• What is included in the written cost estimate?