Da Vinci Robotic Surgery

Robotic
Adrenal
Surgery

Mr Smellie performs adrenal surgery using the Da Vinci robotic system — delivering unparalleled precision in one of the most technically demanding areas of abdominal surgery. The robotic approach offers patients smaller incisions, reduced blood loss and faster recovery.

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What are the Adrenal Glands?

The adrenal glands are two small but vital organs that sit just above each kidney. They produce hormones essential to life — including cortisol (the stress hormone), aldosterone (which controls blood pressure) and adrenaline.

Adrenal tumours can be either functional — producing excess hormones with significant effects on blood pressure, metabolism and wellbeing — or non-functional, discovered incidentally on scans performed for other reasons (adrenal incidentaloma). Even non-functioning tumours may require surgical removal if they are large or growing.

Surgery to remove an adrenal gland (adrenalectomy) is the definitive treatment for most adrenal tumours. The retroperitoneal location of the adrenal glands makes them particularly well-suited to robotic surgical access, where the Da Vinci system provides superb 3D visualisation and instrument precision.

Adrenal Conditions Treated
Adrenal adenoma (benign tumour)
Phaeochromocytoma (adrenaline-secreting tumour)
Conn's syndrome (primary hyperaldosteronism)
Cushing's syndrome (cortisol excess)
Adrenocortical carcinoma
Adrenal incidentaloma requiring removal
Metastatic deposits to the adrenal gland
Why Robotic Adrenal Surgery?
Precision in Confined SpaceThe adrenal glands are small and deeply positioned — the Da Vinci robot excels in this anatomy
Minimal Blood LossRobotic dissection minimises bleeding — critical when operating near major vessels
Smaller IncisionsThree small ports replace a large open incision, reducing pain and scarring significantly
Faster RecoveryMost patients go home within 1–2 days and return to normal life within 2–3 weeks
3D HD Visualisation10x magnified 3D view allows identification of delicate structures including the adrenal vein
Conditions

Adrenal Conditions in Detail

01
Phaeochromocytoma
A tumour of the adrenal medulla that secretes excess adrenaline and noradrenaline, causing episodic hypertension, headache, sweating and palpitations. Surgical removal is curative but requires specialist anaesthetic management. The robotic approach minimises handling of the tumour.
02
Conn's Syndrome
Primary hyperaldosteronism caused by an aldosterone-secreting adenoma leads to resistant hypertension and low potassium. Robotic adrenalectomy is curative in unilateral disease, often eliminating the need for lifelong antihypertensive medication.
03
Cushing's Syndrome
Excess cortisol production causes weight gain, hypertension, diabetes and osteoporosis. Adrenal Cushing's — caused by a cortisol-secreting adrenal adenoma — is treated by robotic adrenalectomy with excellent long-term outcomes.
04
Adrenal Incidentaloma
Adrenal masses discovered incidentally on imaging require careful evaluation. Those with concerning features on CT/MRI, evidence of hormonal activity, or significant size (typically >4cm) are recommended for surgical removal to exclude malignancy.
The Operation

Robotic Adrenalectomy — What to Expect

Robotic adrenalectomy is performed under general anaesthesia. Mr Smellie uses a transperitoneal approach — entering through the abdominal cavity — using three or four small ports of 8–12mm. The Da Vinci robotic arms are inserted through these ports and the surgeon operates from a console with a full 3D view of the operative field.

The adrenal gland is carefully dissected from the surrounding fat and major vessels. The adrenal vein — the key vessel supplying the gland — is identified and divided. The entire gland is then placed in a specimen bag and removed through one of the small port sites.

Special precautions are taken for phaeochromocytoma, where close collaboration with the anaesthetic team is essential to manage blood pressure fluctuations during tumour manipulation.

Mr Smellie works as part of the multidisciplinary endocrine team at Cleveland Clinic London, with specialist endocrinology, radiology and pathology input for all adrenal cases.

Recovery Timeline
Day of surgery: admitted, operation, recovery
Day 1–2: discharge home in most cases
Week 1–2: light activities at home
Week 2–3: return to desk work
Week 3–4: driving and most normal activities
Week 6: follow-up with hormone checks
Pre-operative Assessment

All patients require specialist biochemical assessment before adrenal surgery, including screening for hormonal activity. Mr Smellie will arrange all necessary investigations and work closely with endocrinology colleagues to optimise you for surgery.

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Concerned About an Adrenal Tumour?

Mr Smellie offers expert assessment and Da Vinci robotic adrenal surgery at Cleveland Clinic London. Early assessment is always recommended.

0800 098 1942
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