The adrenal glands are two triangular organs that sit on top of the kidneys. They're primarily responsible for releasing a number of important regulatory hormones, including epinephrine (adrenaline), norepinephrine, aldosterone and cortisol. There are several reasons why an adrenal gland may need to be operated on. One is when a benign tumor on the adrenal cortex—the outer part of the gland—causes the adrenal gland to produce too much of a certain hormone, thereby interfering with the body's regulatory processes. These tumors, called functional adrenal adenomas (because they alter the function of the adrenal gland), are quite rare but can lead to significant abnormalities when they occur, including high blood pressure and weight gain. Two of the most common are Cushing's syndrome, associated with excess production of cortisol, and Conn's syndrome, linked to excess aldosterone. When the adrenal gland's inner layer (medulla) creates a tumor, it is referred to as a pheochromocytoma—a very serious condition that leads to the overproduction of epinephrine. Symptoms often include elevated blood pressure, elevated heart rate and headaches.
Surgical removal of functional adrenal tumors is essential in order to avoid long-term health problems. Other reasons for adrenal gland surgery include a malignant tumor on the gland (known as adrenocortical carcinoma, adrenal cortex cancer, or simply adrenal cancer) or cancer that has spread to the adrenal gland from another part of the body. In many cases it may be necessary to treat functional adrenal tumors by removing the entire adrenal gland, a procedure called radical adrenalectomy. At NYU Langone's Robotic Surgery Center, however, our urologic surgeons are often able to remove these tumors while preserving the rest of the adrenal gland—a procedure known as partial adrenalectomy. We are able to perform this advanced procedure largely because of the enhanced capabilities that the da Vinci Si surgical system provides to the operating surgeon, including improved precision of dissection, enhanced suturing capabilities, and the ability to import real-time ultrasound images into the console.