About the Adrenal Glands
The adrenal glands are two small, triangular glands located on top of each kidney. Despite their size, they play a critical role in the body's hormonal regulation, producing cortisol (the stress hormone), aldosterone (which regulates blood pressure and electrolytes), and catecholamines (adrenaline and noradrenaline). Tumors of the adrenal glands — whether benign or malignant, functioning or non-functioning — may require surgical removal.
At a Glance: Adrenal Conditions
Pheochromocytoma — excess adrenaline causing severe hypertension episodes.
Aldosteronoma (Conn's Syndrome) — excess aldosterone causing high blood pressure and low potassium.
Cortisol-producing adenoma — excess cortisol causing Cushing's syndrome.
Adrenal incidentaloma — a mass found incidentally on imaging that may need removal based on size or hormonal activity.
Conditions Requiring Adrenal Surgery
Pheochromocytoma
A pheochromocytoma is a tumor of the adrenal medulla that produces excess catecholamines, causing episodes of severe hypertension, headaches, sweating, and rapid heartbeat. Surgery is the definitive treatment. Careful preoperative preparation with medications to control blood pressure (typically alpha-blockade) is essential before proceeding to the operating room.
Aldosteronoma (Conn's Syndrome)
An aldosterone-producing adenoma causes primary hyperaldosteronism, leading to hypertension and low potassium levels. When the condition is caused by a single adrenal adenoma (confirmed by adrenal vein sampling), surgical removal of the affected gland often cures or significantly improves the hypertension.
Cortisol-Producing Adenoma (Cushing's Syndrome)
An adrenal adenoma producing excess cortisol can cause Cushing's syndrome, characterized by weight gain, easy bruising, muscle weakness, diabetes, and osteoporosis. Adrenalectomy removes the source of excess cortisol production.
Adrenal Incidentaloma
With the increased use of CT and MRI scans, adrenal masses are frequently discovered incidentally during imaging performed for other reasons. These “incidentalomas” are usually benign, but surgery may be recommended if the tumor is larger than 4 cm, demonstrates growth on serial imaging, has suspicious radiographic features, or is found to be hormonally active.
The Procedure: Minimally Invasive Adrenalectomy
Dr. Abbassi performs adrenalectomy using minimally invasive techniques — either laparoscopic or robotic-assisted. The adrenal glands sit in a deep, confined space surrounded by major blood vessels, making the precision of robotic instruments particularly valuable. The minimally invasive approach results in less blood loss, less pain, and a shorter hospital stay compared with open surgery.
Recovery
- Hospital stay: One to two nights for most patients
- Pain: Generally mild, managed with oral medication
- Return to activity: Most patients resume normal activities within two to three weeks
- Hormonal follow-up: Endocrinology follow-up is important, particularly for functioning tumors, to confirm hormone levels have normalized after surgery
Multidisciplinary Care
Adrenal surgery is a collaborative effort. Dr. Abbassi works closely with endocrinologists, who manage the hormonal workup and preoperative preparation, and with radiologists, who provide the imaging characterization of the adrenal mass. This team-based approach ensures each patient in the Rockwall, McKinney, and North Texas area receives thorough evaluation and optimal surgical timing.