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Adrenalectomy - surgical approaches

Adrenalectomy means removing part or all of an adrenal gland. Four approaches are in common use. The right one depends on the size of the tumour, its hormone profile, whether cancer is suspected, and patient factors.

Robotic adrenalectomy

Minimally invasive using the da Vinci platform. Small keyhole incisions, 10x magnified 3D view. Preferred for most adrenal tumours in experienced centres.4

Single-port adrenalectomy

All instruments through one small incision using the da Vinci SP platform. Selected cases.

Laparoscopic adrenalectomy

Conventional keyhole surgery with rigid laparoscopic instruments. Still widely used and has robust long-term outcomes when an experienced team is available.8

Open adrenalectomy

Reserved for very large tumours, suspected invasive cancer, or when a minimally invasive approach cannot safely achieve complete removal with an intact capsule.

How the choice is made

Several factors go into deciding the approach:

  • Tumour size and imaging features. Smaller, well-defined tumours are usually suitable for minimally invasive surgery. Very large tumours, or those with invasion into surrounding vessels, may need an open approach.
  • Suspected malignancy. For adrenocortical carcinoma the priority is complete resection with an intact tumour capsule; the route chosen is whichever reliably achieves that.8
  • Hormone profile. Phaeochromocytoma requires pre-operative alpha-blockade and a specialised anaesthetic plan; Cushing's requires steroid cover.
  • Patient factors. Prior abdominal surgery, body habitus, and overall fitness all influence which approach is safest.

The best outcomes come from teams that perform adrenal surgery regularly and are comfortable with all four approaches.

Patient information brochures

General-interest leaflets from the British Association of Urological Surgeons.

PDF Laparoscopic removal of the adrenal gland BAUS patient information leaflet → PDF Open removal of the adrenal gland BAUS patient information leaflet →

Considering adrenal surgery?

You can request a second opinion on imaging, hormone testing and treatment options before you decide.

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