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Surgical anatomy of the adrenal glands

Sanziana Roman, MD
Leslie Wu, MD
Section Editor
Sally E Carty, MD, FACS
Deputy Editor
Wenliang Chen, MD, PhD


The adrenal glands are essential to normal physiologic functioning. Significant pathology requiring surgical intervention may result from hyperplasia, adenoma formation, or malignancy.

Adrenal surgery often is the primary treatment modality for a multitude of adrenal conditions. As a result, a strong working knowledge of adrenal embryology and anatomy is essential. Adrenalectomy can be performed by open or laparoscopic techniques with use of various approaches (anterior, lateral, or posterior) [1,2]. Regardless of the operative approach, the surgeon must have a complete understanding of the anatomy of the adrenal gland to avoid injury to vital adjacent structures and organs [3,4].

This topic will review surgical anatomy of the adrenal glands. Surgical diseases of the adrenal gland, diagnosis, and treatment are discussed elsewhere. (See "Basic principles in the laboratory evaluation of adrenocortical function" and "Clinical presentation and evaluation of adrenocortical tumors" and "Treatment of pheochromocytoma in adults" and "The adrenal incidentaloma".)


The adrenal glands are composed of two functionally distinct endocrine units, the adrenal cortex and medulla, contained within a single capsule (figure 1). Each has distinct embryologic, anatomic, histologic, and functional characteristics [5].

Adrenal cortex function — The adrenal cortex is divided into three functional zones (figure 2).


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Literature review current through: Sep 2016. | This topic last updated: Jun 30, 2015.
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