Adrenal Surgery

Adrenalectomy is a surgical procedure to remove one or both adrenal glands. While adrenal tumors are uncommon, they can lead to significant symptoms — such as high blood pressure, heart palpitations, and weight gain—due to excess hormone production. The choice of surgical approach depends on the tumor’s size, location, and whether cancer is suspected.

Most adrenalectomies are performed using minimally invasive techniques through small incisions, either through the abdomen or the back, using a camera and specialized instruments. In cases involving large tumors or suspected cancer, an open surgical approach may be necessary.

Adrenal surgery was once only performed through a large open incision, often requiring a hospital stay of about a week. While open adrenalectomy is still necessary for very large tumors or cases with a high suspicion of cancer, most adrenal surgeries today are done using minimally invasive techniques. Since the 1990s, laparoscopic approaches have become the standard of care for non-cancerous adrenal tumors.

At the BIDMC Adrenal Center, we perform the majority of adrenal tumor removals laparoscopically. This approach offers several benefits, including less pain, faster recovery and better cosmetic outcomes. We also provide robotic-assisted laparoscopic adrenalectomy, which can be done through either the abdomen or the back, offering patients additional precision and flexibility in treatment.

Laparoscopic Transabdominal Adrenalectomy

Laparoscopic transabdominal adrenalectomy is a minimally invasive procedure performed through 3 to 4 small incisions in the abdomen. Using a tiny camera and specialized instruments, surgeons remove the adrenal gland with precision. Introduced in the 1990s, this approach has become the standard of care for non-cancerous adrenal tumors, offering patients significantly less pain, reduced blood loss, fewer complications and faster recovery compared to traditional open surgery.

Laparoscopic Retroperitoneal Adrenalectomy

Laparoscopic retroperitoneal adrenalectomy is performed through three small incisions in the back, just below the ribcage, using a small camera and laparoscopic instruments. Developed in the late 2000s, this technique is increasingly being adopted by expert centers nationwide. The main benefits of the retroperitoneal approach are direct access to the adrenal glands without needing to manipulate abdominal organs, leading to less pain and faster recovery compared to the transabdominal method. It is also an excellent option for patients who have previously undergone abdominal surgery.

Robotic Adrenalectomy

Robotic adrenalectomy is performed in a similar manner to laparoscopic surgery, with 3 to 4 small incisions made either through the abdomen or the back. However, unlike conventional laparoscopy, the robotic approach uses a highly advanced robotic system controlled by the surgeon. This technology enhances visualization and precision, allowing for more detailed dissection and improved outcomes.

Recovery: Most patients experience minimal pain and can typically leave the hospital the day after surgery, though recovery time may vary depending on the type of adrenal tumor treated. You can gradually resume normal activities as you feel comfortable, but it's important to avoid heavy lifting for the first 6 weeks. Generally, patients return to work 1-2 weeks after surgery, depending on individual recovery.

Diet: You can resume a normal, balanced diet immediately after surgery, with no restrictions on food or drink.

Wound Care: We use absorbable stitches to close your wound, so there’s no need for removal. Adhesive bandages or skin glue are applied to promote healing and will naturally peel off within 1-2 weeks.

Hygiene: You may shower the day after surgery, but should avoid rubbing the wound. Gently pat the area dry, and refrain from submerging the wound in water (e.g., bathing, swimming) for 2 weeks.

Pathology Results: It usually takes at least 7 working days for your pathology results (the analysis of tissue removed during surgery) to be available. You will receive a message from your surgeon’s office to review the results once they are ready.