Adrenal surgery
Adrenal gland tumors are fairly common, and when they occur they require careful care to determine if they are producing too much adrenal hormone that can cause severe disease.
Adrenal surgeons in Tampa
At the Hospital for Endocrine Surgery, a part of HCA Florida South Tampa Hospital, we perform more of these surgeries than anyone.
Our team of nurses, technicians, and surgeons are committed to adrenal tumors and adrenal surgery expertise. Together, they will work with each patient to develop a personalized treatment plan to help assure patient goals and objectives are met.
Related specialties
Learn more about our related specialties
Conditions we treat
We treat various types of adrenal gland tumors, including:
- Aldosterone secreting tumors (Conn's syndrome)
- Cortisol secreting tumors (Cushing's syndrome)
- Pheochromocytoma (adrenal medulla tumor)
- Bilateral adrenal hyperplasia (Cushing's disease)
- Non-functional adrenal adenomas
- Adrenal cancer
Diagnosis and treatment of adrenal tumors
Adrenal gland tumors are fairly common, and when they occur they demand respect and a careful workup to determine if they are producing too much adrenal hormone that can cause severe disease.
Types of treatment for adrenal tumors
Adrenal surgery can be performed many different ways. The specific adrenal surgical technique used will be dictated by the situation at hand. It is crucial that your adrenal surgeon is comfortable with all different techniques of adrenal surgery since a customized, individual approach will give the best possible outcome. Adrenal surgery should be tailor-made for you and your specific tumor.
Types of surgeries we offer include:
- Mini-back-scope adrenalectomy (best surgical option for 90% of adrenal tumors)
- Open trans-abdominal adrenalectomy (for large adrenal masses and cancers)
- Trans-peritoneal adrenalectomy (for large adrenal masses and cancers)
The Mini-Back-Scope Adrenal Operation
Almost all adrenal tumors (>95%) can now be removed using minimally invasive techniques such as the Mini Back Scope Scope Adrenalectomy. This operation is also called "Posterior Retroperitoneoscopic Adrenalectomy".
There are many reasons the minimally invasive Mini-Back-Scope Adrenal operation is preferred over any of the other adrenal operations. It is performed with a scope (fiberoptic camera) via three small incisions in the lower part of the back of the patient. Since the adrenal glands are in the very back part of your abdomen, behind all the other organs, getting to them through the back with a small scope and fine endoscopic instruments makes total sense and has many tremendous benefits—but few surgeons know how to do it. It is not taught in surgical residency because no surgeons see enough cases of adrenal surgery to learn it. Our surgeons use this advanced operation on about 95% of our adrenal patients, and it typically takes about 30 minutes total time.
Adrenal vein sampling
Primary hyperaldosteronism, or Conn’s syndrome, is due to overproduction of the very toxic hormone, aldosterone, from the adrenal glands. The disease can be due to a single tumor on one of the adrenal glands (left or right) or too much aldosterone from both adrenal glands.
Adrenal vein sampling (AVS) is an X-ray study to figure out Does the patient have too much aldosterone production from one or both adrenal glands? Which adrenal gland harbors the [related] tumor, the left or right?
Adrenal vein sampling is an interventional radiology study performed by radiologists trained specifically in performing invasive procedures using catheters. Adrenal vein sampling is needed when the adrenal CT scan does not show a tumor (the tumor is too small to be detected on a CT or MRI scan) or in patients who have adrenal tumors on both the right and the left side. Through small catheters, blood samples are obtained from each adrenal vein and the inferior vena cava.
Not all patients with primary hyperaldosteronism need adrenal vein sampling. Patients who are young, have an obvious tumor on the CT scan, and with a completely normal adrenal gland on the other side, do not need the study.
About adrenal gland tumors
Adrenal tumors can be either benign or malignant although the vast majority of adrenal tumors are benign (not cancer). The older we get, the more likely we are to develop an adrenal tumor. A 20-year-old only has about a 0.2% chance of having an adrenal tumor, whereas when we get to 70 years old, almost 7% have an adrenal tumor. The good news is that over 95% of adrenal tumors are benign.
Symptoms of adrenal tumors
Even though the overwhelming majority of adrenal tumors are benign (non-cancerous), many of them cause significant and often dramatic symptoms because they produce excess adrenal hormones. Adrenal tumors that produce hormones nearly always need to be removed because the excess hormones can cause toxic effects within your body, make you feel miserable and cause early death. Too much adrenal hormones such as aldosterone, cortisol and catecholamines (adrenaline-type hormones; epinephrine, norepinephrine, and dopamine) can create very toxic effects on the body long term.
If some of this seems overwhelming, no worries. We do this every day and we will hold your hand through every aspect of your diagnosis and treatment.
Functional (hormone-producing) adrenal tumors
Adrenal tumors that produce hormones are called "functional" adrenal tumors. Unfortunately, hormone-producing adrenal tumors almost always produce too much of hormone and this excess hormone causes tremendous symptoms and illness. It is important to understand that most functional adrenal tumors are benign (non-cancerous). That means, if your adrenal tumor produces too much cortisol, aldosterone or adrenaline-type hormones (catecholamines) it is almost always benign.
Our adrenal surgeons operate on as many as 12 people per week with functional adrenal tumors. Most of these adrenal operations are performed via a mini-scope operations (Mini Back Scope Adrenalectomy) which typically takes our surgeons about 30 minutes and the patient has only a few small Band-Aids on their lower back.
Do functional adrenal tumors need to be removed?
Yes, nearly all functional adrenal tumors need to be removed. Not primarily because of the concern for cancer, but because the damage caused to the body due to excess of these "toxic" hormones can be life-threatening. If you have a functional adrenal tumor, you need an adrenalectomy.