Surgical anatomy of the adrenal glands
- Sanziana Roman, MD
Sanziana Roman, MD
- Professor of Surgery (Endocrine Surgery)
- Duke University School of Medicine
- Leslie Wu, MD
Leslie Wu, MD
- Surgical Attending
- Maine Medical Center and Mercy Hospital
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 .
Adrenal cortex function — The adrenal cortex is divided into three functional zones (figure 2).
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- Adrenal cortex function
- Adrenal medulla function
- Abnormal function
- Extra-adrenal gland anatomy
- SIZE AND LOCATION
- Right adrenal gland location
- Left adrenal gland location
- BLOOD SUPPLY
- VENOUS DRAINAGE
- Venous drainage left adrenal gland
- Venous drainage right adrenal gland
- LYMPHATIC DRAINAGE