Adrenal Surgery

Adrenal surgery is indicated when certain benign or malignant growths of the adrenal glands are detected. We understand that successful surgical outcomes require meticulous teamwork between the pre-operative and post-operative medical care teams, and the intra-operative surgical teams. As a result, physicians of all disciplines at the Center for Adrenal Disorders work together to build the optimal surgical plan when an operation is indicated. Our surgical teams are dedicated to achieving the following goals:

  • To perform safe and effective adrenal surgery when indicated
  • To work with medical endocrinologists, oncologists, and anesthesiologists to identify the safest and most effective surgical treatment plan for each individual patient.
  • To perform the optimal minimally invasive procedure to minimize pain and adverse events to the patient, and maximize the time to recovery and good health.

Our specialized endocrine surgeons have expertise in performing minimally invasive adrenal surgery. We work closely with anesthesiologists and operating room nurses who are passionate and especially interested in caring for patients with adrenal tumors before, during, and following surgery.

When possible, we strive to use endoscopic techniques to remove adrenal tumors through incisions that are less than an inch in length. This form of “laproscopic adrenalectomy” has revolutionized our ability to perform procedures with shorter recovery times, less pain, and fewer complications, than conventional adrenal surgeries. In addition to anterior laparoscopic adrenal surgery, our surgeons are uniquely skilled in performing “retroperitoneoscopic adrenalectomy.” This surgery involves a more direct and even more minimally invasive procedure by avoiding the anterior approach, and instead approaching the adrenal glands posteriorly. Our surgeons are among the few in the world with the experience and skill to perform this wide array of adrenal surgical procedures. For many adrenal surgeries, patients are able to leave the hospital within 24 hours of the procedure and can resume normal activities within a few weeks.

Your visit

A typical visit to the adrenal surgeon involves a historical recount of the condition as well as a physical examination. Physicians will review relevant laboratory results and radiology images with the patient. When necessary, physician surgeons may order additional imaging tests to allow the best visualization of relevant anatomy. Together with the patient, surgeons will explain the possible surgical procedures that could be indicated, the relevant risks and benefits of each, and help the patient choose the most appropriate procedure. A date for the surgery will be arranged, and most patients will undergo an evaluation with an anesthesiologist before the procedure to review the anesthesia protocol and relevant medical conditions that may need special attention during the operation. During this time, patient’s will continue to work with their medical endocrinologists and oncologists when indicated, to optimize their health status for the surgery and for the post-operative recovery period.

Services offered

  • Laproscopic adrenalectomy
  • Retroperitoneoscopic adrenalectomy
  • Open (conventional) adrenalectomy

Personnel

  • Dr. Daniel Ruan, MD
    • Endocrine surgeon with specialization in adrenal surgeries

Dr. Daniel Ruan graduated from Duke University School of Medicine and completed his surgical residency at the Brigham and Women’s Hospital. He completed a specialty fellowship in Endocrine Surgery at the University of California San Francisco, and is currently a faculty member in the Department of Surgery at the Brigham and Women’s Hospital and Harvard Medical School. He has a special interest in adrenal disorders including pheochromocytoma, hyperaldosteronism, Cushing’s disease, and benign and malignant adrenocortical tumors. Dr. Ruan is regarded as an expert in minimally invasive surgery of the adrenal glands. Laparoscopic adrenalectomy involves the use of special instruments through "keyhole" incisions. In comparison to conventional adrenal surgery, the laparoscopic approach minimizes postoperative pain and shortens the recovery period. Retroperitoneoscopic adrenalectomy is a new minimally invasive technique that utilizes a more direct approach through the back to access adrenal tumors. It is best suited for patients with a history of previous abdominal operations and patients that require surgery on both adrenal glands. Dr. Ruan is one of the few surgeons with experience using this newer minimally invasive approach to adrenal surgery.

The new AMIGO (Advanced Multimodality Image Guided Operating) suite at Brigham and Women's is a unique operating room that allows surgeons to use MRI coupled with real-time ultrasound guidance. Dr. Ruan is the first surgeon to apply this technology to perform cortical sparing adrenalectomy. The AMIGO suite technology allows Dr. Ruan to localize small adrenal tumors in the operating room, which can facilitate their removal while sparing some of the surrounding normal adrenal tissue.

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