Surgery for Adrenal Tumors

Doctors treat adrenal tumors using one of two surgical procedures: a total adrenalectomy, meaning that the adrenal gland is completely removed, or a partial adrenalectomy, meaning that only part of the adrenal gland is removed. In these procedures, small incisions are typically made in the abdomen, but NYU Langone doctors also have expertise in removing adrenal tumors through the lower back.

Performing surgery through the back may be necessary in people who have abdominal scarring from prior surgery.

Total Adrenalectomy

To treat large functional adrenal tumors, doctors may need to remove the entire adrenal gland. Although the adrenal glands are essential for life, one gland can usually do the work of both. Doctors also remove the entire gland if you have a cancerous tumor called an adrenocortical carcinoma or if you have cancer that has spread to the adrenal gland from another part of the body.

Partial Adrenalectomy

Partial adrenalectomy involves removing a noncancerous, functional tumor from the adrenal gland while leaving the rest of the gland intact.

Whenever possible, doctors at NYU Langone use minimally invasive surgery. These approaches include laparoscopic and robotic-assisted surgery.

Laparoscopic Surgery   

Doctors can often perform radical adrenalectomy and partial adrenalectomy by making just three or four tiny incisions in the abdomen or back. During the procedure, doctors insert a laparoscope—a thin, lighted tube with a camera on one end that creates two-dimensional images on a monitor. Surgical instruments are inserted through the laparoscope to remove the tumor. 

Smaller incisions allow people to recover faster—and with less pain and scarring—than with open surgery. At NYU Langone, all of our surgeons have specialized training in laparoscopic surgery.

Robotic-Assisted Surgery  

The surgeons at NYU Langone's Robotic Surgery Center have expertise in using robotic-assisted surgery to remove benign and cancerous adrenal tumors. This equipment consists of tiny surgical instruments mounted on several robotic arms. An additional arm has a camera that generates magnified, three-dimensional images on a computer screen to help guide the surgeon during the operation. 

During the procedure, the surgical instruments and camera are inserted through small incisions in the abdomen. The surgeon controls these instruments and the camera from a console located in the operating room.

NYU Langone surgeons were among the first to regularly perform robotic-assisted partial adrenalectomy. The procedure allows for better visualization of the tumor and more precise operating techniques. 

Because robotic-assisted surgery is performed in conjunction with real-time ultrasound images—the use of sound waves to create pictures of the body—doctors are able to identify and remove a tumor more easily. 

Most people who have had robotic radical adrenalectomy leave the hospital one to three days afterward, compared with four or five days with open surgery.

Open Surgery 

During open surgery, surgeons make a long incision in the abdomen to remove the adrenal gland tumor. Open surgery may be used in people who have scar tissue in the abdomen, which can make minimally invasive approaches more difficult. Doctors may also use open surgery to remove large cancerous adrenal tumors.