The adrenal glands are hormone-producing glands located just above the kidneys. Tumors on these glands can cause debilitating conditions, but now cutting-edge surgery is helping some patients restore quality of life.

Additional information on this report from Medstar Television:

The Adrenal Glands

The adrenal glands are a pair of small, triangular-shaped glands located in the
abdomen. One gland sits on the top of each kidney. The outer section of the
gland is called the adrenal cortex. The inner part is the adrenal medulla.



The adrenal glands make hormones needed by the body. The adrenal cortex produces
cortisol (a hormone used to help the body handle stress and help the body
metabolize glucose, protein and fats), aldosterone (to regulate salt levels and
blood pressure) and a small amount of sex hormones (androgens in men and
estrogens in women). The adrenal medulla produces the stress hormones,
norepinephrine and epinephrine.



Adrenal Tumors

Most tumors that affect the adrenal gland are small and benign. They usually
don’t cause any obvious symptoms and may only be found during a CT or MRI
screening for another, unrelated problem.



In some cases, an adrenal tumor can cause excess production of hormones.
Patients may experience severe headaches, anxiety, palpitations, sweating, and a
rapid heart rate. Overproduction of cortisol can lead to the development of
Cushing’s syndrome, a condition characterized by obesity, high blood pressure,
high glucose levels, menstrual problems, fragile skin and stretch marks. Excess
production of aldosterone can cause high blood pressure and low potassium
levels.



In rare cases, an adrenal tumor is a malignant growth. The American Cancer
Society estimates only about 300 to 500 cases of adrenal cancer occur every year
in the U.S. It’s most common in adults 45 to 50. Women are affected more often
than men.



Adrenalectomy

An adrenalectomy is the surgical removal of the adrenal gland. In the past,
doctors would make a 6 to 12 inch incision into the abdomen or side to access
and remove the gland. An alternative method of surgery is laparoscopy (called a
laparoscopic adrenalectomy). Surgeons make three to four small incisions. Then,
tiny surgical instruments are used to move aside internal organs and cut out all
or a part of the affected gland.



Laparoscopic adrenalectomy is currently the preferred method of surgery for
benign adrenal tumors. The smaller incisions mean less blood loss during
surgery, less pain and a faster recovery. Most patients are able to leave the
hospital in one to two days.



A “Backward” Approach

Terry C. Lairmore, M.D., a Surgical Oncologist with Scott and White in Temple,
TX, says that although laparoscopic adrenalectomy is very popular, there is one
drawback. The adrenal glands are located closer to the back, rather than the
front of the body. Therefore, during laparoscopy, the surgeon must move vital
organs to the side to get at the affected gland.



Lairmore is using a different approach to laparoscopic adrenalectomy. Instead of
making the incisions in the abdomen or side, he makes them in the back. Only
three small incisions are needed. Surgeons have direct access to the adrenal
glands and don’t need to push aside any of the vital organs. Lairmore says
even the time needed for the operation is reduced.



The back approach for laparoscopic adrenalectomy isn’t for everyone. Patients
with larger tumors or those who are obese may require the traditional
laparoscopic approach, or even open surgery.



For general information on adrenal tumors:

American Cancer Society, http://www.cancer.org

National Cancer Institute, http://www.cancer.gov



General information about laparoscopic adrenalectomy is available from the
Society of American Gastrointestinal and Endoscopic Surgeons at http://www.sages.org

BIBLIOGRAPHY“Adrenal Cortical Cancer,” Atlanta:
American Cancer Society, http://www.cancer.org



“Adrenocortical Carcinoma (PDQ®),” Bethesda: National Cancer Institute,
downloaded from website (http://www.cancer.gov),
August 22, 2007.



Castillo, O., et al., “Laparoscopic Adrenalectomy for Suspected Metastasis of
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Hallfeldt, K., et al., “Laparoscopic Lateral Adrenalectomy Versus Open
Posterior Adrenalectomy for the Treatment of Benign Adrenal Tumors,” Surgical
Endoscopy, February 2003, Vol. 17, No. 2, pp. 265-267.



“Laparoscopic Adrenal Gland Removal,” Los Angeles: The Society of American
Gastrointestinal and Endoscopic Surgeons, downloaded from website (http://www.sages.org),
August 22, 2007.



Lezoche, E., et al., “Anterior, Lateral, and Posterior Retroperitoneal
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Skarsgard, Erik, M.D., and Craig Albanese, M.D., “The Safety and Efficacy of
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Superstein, Allan, M.D., et al., “Laparoscopic Posterior Adrenalectomy,” Archives
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Suzuki, Kazuo, M.D., Ph.D., “Laparoscopic Adrenalectomy: Retroperitoneal
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Walz, Martin, M.D., et al., “Posterior Retroperitoneoscopic Adrenalectomy,” Surgery,
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Zhang, X., et al., “Technique of Anatomical Retroperitoneoscopic Adrenalectomy
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Research compiled and edited by Barbara J. Fister