The adrenal gland (surrenal) is a hormone-producing organ located on both kidneys, which has little relationship with the kidney, contrary to popular belief, in terms of both function and origin.
While cortisol, which plays a role in our body's fight against stress, aldosterone and some androgens, which are involved in the water-salt balance, are released from the outer layer of the adrenal gland, two hormones called adrenaline and noradrenaline are released from the inner layer and play a role in our alert state during fear and excitement.
While the masses in the adrenal gland are mostly found incidentally (incidentaloma) in ultrasonography, tomography or MR imaging performed for another reason, the majority of them are benign and non-surgical lesions.
Sometimes, these detected masses require surgical intervention both by producing uncontrolled hormones and by pre-diagnosis of cancer.
Cushing's syndrome, which consists of a wide range of complaints and findings such as weight gain, fat in the body, hypertension, weakness, depressed mood, elevated blood sugar, impaired wound healing and frequently recurring infections, purple cracks in the abdomen, chest and hips, is the most common symptom of adrenal gland masses. It is a hormonal disorder.
Pheochromocytoma, which is known as attacks of resistant and fatal hypertension, and Conn's syndrome, which also presents with symptoms such as high blood pressure, muscle weakness, headache, and excessive urination at night, are conditions that require surgical removal of the adrenal gland as a result of uncontrolled hormone release.
In addition, adrenal masses with cancer signs on MRI or tomography or with a risk of cancer due to their size (4-5 cm) also require surgical intervention. And hormone active adrenal gland needs to be removed.
Yes adrenalectomy due to overactivity of adrenal gland and suspicions of cancer is a major surgery. But laparoscopic surgeon minimize the risk of adrenalectomy.
One of the biggest concerns of our patients when planning these surgeries is; It is 'Will I lose my kidney too?' While removing the adrenal gland, the kidneys are preserved and they are two different organs.
The adrenal gland is called the surrenal gland only because of its neighborhood (since it is located above the kidney). When planning the operation, the endocrinologist and urologist should make the decision and necessity of the operation together.
As in other surgeries, laparoscopic adrenalectomy in surgery of the adrenal gland is more advantageous than open surgery in terms of patient recovery, amount of bleeding and cosmetic appearance. I think laparoscopic adrenalectomy is a cost effective surgery in comparision with robotic adrenalectomy.
The best treatment of cushing's disease or syndrome is eleminating of main cause. And the best surgical method is laparoscopic adrenalectomy for adrenal tumors.
Yes. If the main cause is excess cortizol secreted from the adrenal gland, cure will be achieved after adrenalectomy.
Removal of the adrenal gland with the laparsocopic method is a safer operation and provides a fast recovery process
Laparoscopic adrenal gland surgery costs range from 5000 to 8000 USD in Turkey (More information: Whatsapp: +90 532 485 0016)
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Assoc. Prof. Dr. Arif DemirbasUrology Specialist
Assoc. Prof. Dr. Arif Demirbaş
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