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One-Visit Adrenal Tumor Diagnosis and Treatment Program

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Dr. Tobias Carling MD, PhD, FACS
Nov 3rd, 2021

One-Visit Adrenal Tumor Diagnosis and Treatment Program

The Carling Adrenal Center, a worldwide destination for the surgical treatment of adrenal tumors, becomes the first center to offer adrenal vein sampling and curative surgery in one visit.

The novel protocol and diagnostic method for adrenal tumors will condense a 2–4-week process of localization of hyper-secreting adrenal tumors and subsequent curative surgery down to just one day. The innovative approach combines highly specialized adrenal vein sampling with rapid adrenal hormone lab testing and then consultation with the world's highest volume adrenal surgeon. If appropriate, a patient may even complete their mini-surgery during that same visit.

Established by Dr. Tobias Carling in 2020, the Carling Adrenal Center located at the Hospital for Endocrine Surgery in Tampa FL, is the highest volume adrenal surgical center in the world. The Center now averages nearly 20 adrenal tumor patients every week that could benefit from this novel diagnostic and treatment approach to address a decades-long problem for patients with adrenal tumors.

The Endocrine Society Clinical Practice Guideline

The Endocrine Society Clinical Practice Guideline recommends adrenal vein sampling (AVS) as the preferred method to select patients with primary hyperaldosteronism for an adrenalectomy.

Adrenal Vein Sampling Should Only Be Performed By Experts

"The difficulty and complexity of testing and diagnosing adrenal tumors secreting excess aldosterone is the primary reason why less than 5% of these adrenal tumors are diagnosed and treated," says Dr. Carling. "By combining expertise in interventional radiology for adrenal vein sampling and rapid laboratory measurements of adrenal hormones with our unique international consulting capability, we can determine which adrenal gland is bad and whether or not the patient needs that adrenal gland removed."

Adrenal vein sampling is performed through small catheters placed in very specific veins where blood samples are obtained from both adrenal veins and the inferior vena cava. In experienced centers, the bilateral adrenal veins are catheterized and sampled with a success rate exceeding 90%. Technical success is directly associated with operator experience, leading to the recommendation that the procedure only be performed by true experts or the test will very likely be of no help.

Dr. Carling Is World's Most Experienced Adrenal Surgeon

Dr. Carling's very high volume of adrenal surgery for many years has allowed him to publish scientific studies demonstrating that in aldosterone-producing adenomas, there is a strong correlation between the imaging phenotype (i.e., what the tumor looks like on a CT scan), histology (what the tumor looks like under the microscope) and genotype (what gene is mutated in the tumor).

This knowledge allows Dr. Carling and his team at the Hospital for Endocrine Surgery to predict who can go straight to surgery with an excellent outcome, and who may first need adrenal vein sampling to determine which adrenal gland is over-producing the hormone causing significant morbidity and mortality.

With adrenal vein sampling proving lateralization, the next step is surgical removal of the adrenal tumor. Dr. Carling has more experience with all types of adrenal surgery than any surgeon in the United States, but especially with advanced, minimally invasive adrenal operations which are the best options for aldosterone-secreting adrenal tumors. A fellow of the American College of Surgeons, Dr. Carling is a member of both the American Association of Endocrine Surgeons (AAES) and the International Association of Endocrine Surgeons (IAES).

Hospital For Endocrine Surgery

Dr. Carling moved his world-renowned adrenal surgery program from Yale University to Tampa, Florida in early 2020 to start the Carling Adrenal Center. Here, patients needing adrenal surgery have access to the best practices and best techniques the world has to offer.

In January 2022, the Carling Adrenal Center will unite with the Norman Parathyroid Center, the Clayman Thyroid Center and the Scarless Thyroid Surgery Center at the brand-new Hospital for Endocrine Surgery located in Tampa, Florida.


Additional Resources: 

Learn more about the Carling Adrenal Center

Learn more about Dr. Tobias Carling

Learn more about our sister surgeons at the Norman Parathyroid Center, Clayman Thyroid Center and Scarless Thyroid Surgery Center


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Author

Dr. Tobias Carling MD, PhD, FACS

Dr. Carling is the most experienced adrenal surgeon in the United States, and by far the world's most knowledgeable surgeon-scientist when it comes to adrenal gland function and disease, adrenal tumors and cancer, and all forms of adrenal gland surgery. Dr. Carling has more experience with advanced minimally invasive adrenal and endocrine operations than any surgeon in the United States. A fellow of the American College of Surgeons, Dr. Carling is a significant member of both the American Association of Endocrine Surgeons (AAES) and the International Association of Endocrine Surgeons (IAES).
Dr. Carling is the most experienced adrenal surgeon in the United States, and by far the world's most knowledgeable surgeon-scientist when it comes to adrenal gland function and disease, adrenal tumors and cancer, and all forms of adrenal gland surgery. Dr. Carling has more experience with advanced minimally invasive adrenal and endocrine operations than any surgeon in the United States. A fellow of the American College of Surgeons, Dr. Carling is a significant member of both the American Association of Endocrine Surgeons (AAES) and the International Association of Endocrine Surgeons (IAES).
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Now Operating Exclusively at the Hospital for Endocrine Surgery

Great news! We have moved into our new home, the new Hospital for Endocrine Surgery. This hospital is dedicated to endocrine surgery only. There are no COVID patients in our hospital--it does not have a medical ward--just endocrine surgery. This is the safest hospital for you!

The new Hospital for Endocrine Surgery took 3 years to build, and we moved all our surgery to this beautiful new hospital in January, 2022. Having zero COVID patients is great for us, and great for you. There is no chance that we will have to cancel surgery--we are not affected by the virus. All our doctors and staff have been vaccinated and boosted. Vaccinated patients do not need a COVID test prior to surgery. Unvaccinated patients will be given a rapid COVID test when you arrive at the hospital. You can have one family member with you at all times. We are so blessed to have our new Hospital for Endocrine Surgery--it could not open at a better time!

We have been very busy performing adrenalectomies all year long and our protocols for safe care of our patients have been tremendously effective. We are operating at full capacity and are operating on patients from every state and many foreign countries. Many international patients are now coming because of the medical indications, and we test you with a rapid COVID test when you arrive at the hospital. We take special measures to make this the safest place in the world to have your adrenal operation. We promise to take great care of you!

NEW PATIENTS: It typically takes a few days for new patients to get into our system, receive their records, and have a consultation, and then be scheduled for surgery--so this process for new patients continues. We are the best in the world and we will perform your operation as soon as your specific situation requires. Once we can then review your records, we will get you scheduled for the safest, best adrenal operation in the world.

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