There is a surgical adage that speed is the last thing a surgeon should attain. The philosophy behind the adage is that with dedication to one’s patients and repetition, the surgeon gains the knowledge, confidence, and experience necessary to provide safe efficiency yielding ideal patient outcomes.

It is also said that mastery is achieved after doing something thousands of times.  Achieving 1^st chair in the national symphony orchestra, stepping onto the pitch as a starter of an internationally recognized soccer team, representing your country’s colors in the World Cup or the Olympics, or performing adrenal gland removal surgery at the highest level for your patients, all should have the same thing in common: repetition, allowing for excellence and the opportunity for perfection.

Adrenal gland removal surgery

As a surgeon at the super-specialized Hospital for Endocrine Surgery (HFES), excellence is expected, and our patients benefit from our collective experience and expertise. No where else in the world do you (or your loved one) have access to such a specialized team, who has enjoyed the repetition together, striving for perfection during your adrenal gland removal surgery. This is evident by the time needed at the Carling Adrenal Center to achieve best results and some fundamental differences between how the Hospital for Endocrine Surgery attains success versus other (well-known) University Hospital Centers.

Figure 1. Dr. Carling and the other surgeons at the Carling Adrenal Center and the Hospital for Endocrine Surgery have all achieved the very top levels in their field, similar to World Champions or Olympic Athletes.

Adrenal gland removal surgery: How long does it take?

Google the above heading and you will be linked to several well-known University Hospital Centers’ websites across the country. Of the roughly two that actually perform and are willing to post the times it typically takes to complete the best adrenal gland removal surgery, the Mini-Back Scope Adrenalectomy (MBSA),  the sites discuss the surgery taking hours, not minutes. At most university medical centers an adrenalectomy will last 3- 5 hours. At the Carling Adrenal Center (Hospital for Endocrine Surgery), Dr Carling is performing your adrenal gland removal surgery in minutes!

Just last week, Dr Carling performed the MBSA in five consecutive patients on the same day.  His operative times were 11, 11, 10, 12, and 18 minutes! The last patient listed had a BMI (body mass index) greater than 40 (morbidly obese), which makes the operation taking a bit longer. Some Centers use this BMI of 40 as a cut-off for whether the adrenal surgery is offered. This is not the case at the Carling Adrenal Center, where each patient is evaluated as an individual for the best approach to their adrenal gland removal surgery (one size does not fit all). 

Learn more about how a patient’s weight and obesity affects adrenal surgery.

In Dr Carling’s five patients on this particular day, the collective amount of time (62 minutes!) to achieve successful adrenal gland removal surgery was less than other Centers take to almost complete the same procedure in one patient! In other words, Dr Carling’s experience has allowed him to achieve mastery and safe efficiency in your adrenal gland removal surgery. Dr Carling is the Tom Brady, Cristiano Ronaldo, or Roger Federer of adrenal gland removal surgery; however, he did not retire and then unretire, or is about to retire, or did retire; he is just getting started treating patients at the Carling Adrenal Center within the Hospital for Endocrine Surgery, all for your benefit! Dr. Carling has stated that he’d be happy to continue to operate for aa least 2 more decades.

Dr Carling is at the point in his career where he is able to provide his patients the last thing a surgeon should attain, speed. A safe, efficient, and curative adrenal gland removal surgery is best achieved in minutes, not hours. Less anesthesia time, less unnecessary surgical spreading and dissection, and less overall time in the operating room make for more benefits to our patients. Here at the Hospital for Endocrine Surgery, less truly is more. In order to provide this speed, that which all surgeons strive for and have attained at the Hospital for Endocrine Surgery, Dr Carling has performed more than thousand adrenal gland removal surgeries, providing a mastery that no other surgeon in the world can offer.      

Figure 2 Dr. Carling focusing during the left mini back scope adrenalectomy (MBSA)

This mastery translates into speed, allowing benefits to our patients that are unparalleled anywhere else. Less surgery equals less blood loss, quicker recovery times, quicker return to normal activities, and more cost savings to our patients. If you need adrenal gland removal surgery, wouldn’t you like to have it done by the most experienced surgeon, with the best outcomes, all while not paying as much as you would at your local University Center, since you are not in the operating room as long, incurring expensive anesthesia fees?  

Adrenal gland removal surgery: Us vs. Them

Apart from experience translating into mastery equating into speed, all of the greats surround themselves with teams that provide familiarity.  At the Carling Adrenal Center, adrenal gland removal surgery is all we do. The same surgeon, anesthesia, operating room, and nursing teams assemble each day to fine-tune and perfect processes of every adrenal gland removal surgery performed. With familiarity and repetition within the teams, each move is anticipated because it has already been done thousands of times.

Adding “gimmicks” (such as robotic or single incision adrenalectomy) to the already best adrenal gland removal surgery (the MBSA) doesn’t improve operative times and patient outcomes. We have already discussed how robotic adrenal gland removal surgery is not ideal or recommended. A typical robotic adrenal gland removal takes 4-6 hours.

Similarly, single incision surgery (essentially creating one long incision that equals the length of the three incisions used at the Carling Adrenal Center for MBSA), is also not recommended. The MBSA is performed within a small space through the back. Over thousands of cases, we respect the small space and maximize our use of the small space through three small incisions creating the most geometrically sound triangulation of our ports. If three laparoscopic instruments are placed through the same incision, the surgeon is trying something due to their inexperience, not understanding the best use of the space.

Learn more on why laparoscopic adrenal gland removal is not recommended.

The instruments will essentially fight one another with each move the surgeon tries to make. No gimmick improves outcomes, and instead gets in the way of the safe efficiency which we have proven best benefits our patients.

Further, these University Centers are not super-specialized. The surgeons at the University Center will occasionally perform an adrenal gland removal surgery. With the “high volume surgeon” benchmark being more than five adrenal gland removal surgeries in one year, Dr Carling performs 6-8 adrenal gland removal surgeries in one day! The University Center surgeon has to also operate on the thyroid gland, the parathyroid glands, the occasional adrenal gland, and even sometimes has to perform general surgery, like gall bladder, hernia repairs, appendix, and colon removals. The average number of adrenal operations performed by U.S. surgeons who perform adrenalectomy is 1 (one!) per year!

This inability to focus on one organ system (with the same team) makes for unfamiliarity, inefficiencies, and more surgeon stress. We have all heard the saying, “it is better to be excellent at one thing, as opposed to good at multiple things.” This is the surgical mantra of super-specialization; at the Hospital for Endocrine Surgery, we live this mantra. All of our surgeons focus on one organ system, allowing for excellence and the opportunity for perfection with each and every adrenal gland removal surgery.     

Lastly, another fundamental difference between “us” and “them” is that we keep our teams the same WITHOUT the ever-rotating cycle of surgical trainees. The University Center surgeons are beholden to their respective Universities, and thus their surgical trainees. While we have all come from these well-known and well-respected University Centers, and appreciate the training we have received, the Hospital for Endocrine Surgery has built a better system for our patients, one void of people “practicing” on you. We recognize that there is a place for the “practicing,” the University Center. However, if you demand excellence and mastery for you (or your loved one’s) adrenal gland removal surgery, there is really only one place to consider, the Carling Adrenal Center at the Hospital for Endocrine Surgery.

The popular saying, “teamwork makes the dream work,” is embodied by the surgeons and every single team member you encounter at the Carling Adrenal Center and Hospital for Endocrine Surgery. From the Limo bus shuttle driver to the first individual to welcome you into our beautiful, new hospital, to the last nurse to wish you a speedy recovery as you leave our wonderful, clean, and safe confines, we are all there for YOU. We have proven that familiarity and repetition build camaraderie and chemistry translating into safe and efficient adrenal gland removal surgery. Excellent patient outcomes AND the overall best patient experience are OUR benchmarks for success. Why would you consider anywhere else for your endocrine surgery? 

Only the top 0.01% of surgeons are recruited to the Hospital for Endocrine Surgery. If this was the NHL or NFL, our surgeons would all be the top picks in the first round of the draft. We recruit the very best of the best.

Are we bragging? Well, check for yourself! Scrutinize the credentials of our adrenal surgeons, thyroid surgeons and parathyroid surgeons.

Additional Resources: 

• Learn more about the Carling Adrenal Center
• Learn more about our sister surgeons at the Norman Parathyroid Center, Clayman Thyroid Center and Scarless Thyroid Surgery Center
• Learn more about the Hospital for Endocrine Surgery