Bilateral adrenalectomy—simultaneous or delayed?

Bilateral adrenalectomy is an exceedingly rare operation. Less than 1% of patients undergoing adrenal surgery will need a bilateral procedure. As the vast majority of surgeons offering adrenal surgery have a minimal annual workload of under 4–6 cases per year it is imperative to centralise the care of the small number of patients who need bilateral adrenalectomy. This paper reviews the indications for the procedure and comments on its technical feasibility.