Surgery of the Suprarenal Gland

The adrenal glands are paired, retroperitoneal organs and are located antero-medially to the kidneys, near the superior poles at the level of the 11th ribs. The two different zones of the adrenal gland are in essence two distinct endocrine organs. The cortex originates from the mesoderm around the fifth week of gestation near the gonads while the medulla is ectodermal in origin and arises from the neural crest. This chapter describes the surgical anatomy and applied physiology of adrenal glands. It also discusses the etiology, clinical presentation, diagnosis, and management of incidentaloma, pheochromocytoma, and cortical tumors (adenomacarcinoma) shedding light on primary hyper-aldosteronism (Conn’s syndrome), Cushing syndrome, and adrenocortical cancer. In addition, the techniques of bilateral adrenalectomy, both open and laparoscopic, are illustrated in this chapter.