The development of the suprarenal gland: surgical and anatomical considerations

Aim of this research is to study the situation and relationships of the adrenal gland in the first stage of development in order to give some contributes for the application of laparoscopic adrenalectomy; in the meantime we describe the series of the debate changes occurring in the constitution of the cortex and medulla.

Analysis of histologic slices of thoraco-abdominal and abdominal regions of human embryos and fetuses ranging from the fifth (12 mm CR) to the twentieth week (170 mm CR).

At 12 mm CR an unique type of cells is present in the cortex; at 16 mm CR there are two different groups of cells. Sympathogonia enter into the cortex at 16 mm CR. The right adrenal gland seems enclosed into the liver and a ligament containing the middle adrenal vein reaches the vena cava inferior sulcus. The left adrenal gland, through the coelomic cavity, is in relationship with the stomach, the medial border of the spleen and the pancreatic body contained in the primitive dorsal mesogastrium.

The timing of penetration of the ganglion cells into the cortex is defined as well as the hypothesis that the matrix of the fetal and definitive cortex is the same: moreover the study of the early development allows to understand the main characteristics of both the adrenal glands which are significant for a rational and differential laparoscopic approach.