Question: How do I find an endocrine surgeon to do an adrenalectomy and how many procedures should they have done?    

Answer: You can find an endocrine surgeon by checking the American Association of Endocrine Surgeons website at www.endocrinesurgery.org.  This website has a great deal of information about all types of endocrine-related diseases.  In general, adrenalectomy (or surgical removal of the adrenal gland) may be done by urologists or general surgeons with specialized training in minimally invasive surgery and/or endocrine surgery. In general, there is no minimum number of operations that a surgeon must perform to be proficient in this operation.  You should ask your surgeon if they feel comfortable doing the operation (i.e. have done at least 20 adrenalectomies or routinely operate in the area of the adrenal glands).  The surgeon should also be able to connect you with previous patients that you can contact to gauge the results of their operation first-hand.  Otherwise, you can also contact the closest high volume surgery center that has surgeons who specialize in endocrine or adrenal surgery. 

The most common approach for adrenal tumors that are not worrisome for cancer (larger than seven centimeters in size or attached to surrounding structures) is laparoscopic adrenalectomy.  Laparoscopic surgery or “keyhole” surgery is done through several small incisions and a uses a camera to see inside the body.  Large adrenal tumors or tumors that may be cancerous are typically removed through a single open incision along the front, side, or back.  Current research suggests that laparoscopic surgery may be better than open surgery when possible and results in faster recovery and less pain after surgery.  However, there is a small chance that the surgeon will need to “convert” a laparoscopic adrenalectomy to an open adrenalectomy if he/she cannot remove it through the small incisions safely.  If one adrenal gland needs to be removed then the operation is a unilateral adrenalectomy.  If both adrenal glands need to be removed then it is a bilateral adrenalectomy. 

Author: Dr. Roy Phitayakorn, MD MHPE (MEd) FACS (Winter, 2013) 
Editor’s Note: Dr. Phitayakorn is a General and Endocrine Surgeon at Massachusetts General Hospital, Boston, MA and Director of Surgical Education Research.