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Who is the Best Surgeon for Adrenal Tumors?

Who is the Best Surgeon for Adrenal Tumors?

Finding the Unwavering Adrenal Expert

This is, without a doubt, the most important question you will ever ask if you or a loved one has been diagnosed with an adrenal tumor. It’s a question that cuts to the core of your health, your recovery, and your peace of mind.

As the Founder and Director of the Carling Adrenal Center, I have dedicated my entire career, my life's work, to the diagnosis and surgical treatment of adrenal tumors. I say this not as a boast, but as a crucial distinction. When you are facing a tumor on one of your critical, vital adrenal glands, you need a surgeon who is not only excellent but one who is an unwavering, singular specialist.

The truth is, for a rare and complex condition like an adrenal tumor, your surgeon's experience is not just a preference; it is the most critical factor influencing your outcome. If you are seeking the best surgeon for an adrenal tumor, you must search for the one with the highest volume and most advanced, specific expertise in the world.

The Critical Metric: Experience is Everything

In all of medicine, particularly surgery, we know that volume translates directly to better outcomes. This principle is especially true for adrenal surgery because, quite frankly, it’s not common. Most hospitals in the United States perform only a handful of adrenal operations per year, and more than 80% of adrenalectomies in the United States are performed by low-volume surgeons; the typical surgeon who performs adrenal surgery does about one adrenal operation per year. This is a profound and, frankly, concerning statistic that should motivate every patient to look beyond their local hospital.

For us at the Carling Adrenal Center, adrenal surgery is not a sideline; it is the singular focus. When I founded the Carling Adrenal Center, an institute dedicated solely to adrenal disease, I did so to ensure patients could access this critical high-volume expertise.

Let’s put it into perspective: We perform more adrenal operations in a single week than most hospitals perform in an entire year. I am one of the world’s most experienced adrenal surgeons, having performed thousands of adrenal operations over my career, including more than 2,400 since January 2022 alone. About one in eight adrenalectomies in the United States is performed at the Carling Adrenal Center. Why is this critical? Because high volume means:

  • Fewer Complications: Experience minimizes errors and maximizes precision.
  • Faster Recovery: Expertise allows for the use of the least invasive, most advanced techniques.
  • Better Cure Rates: Deep knowledge of tumor pathology helps ensure complete and clean removal.
  • Comprehensive Knowledge: Having seen and treated virtually every type of adrenal tumor, there are few surprises.

Choosing a surgeon whose practice is dedicated to the adrenal gland is the single most important decision you can make. Look for a surgeon who performs adrenalectomies regularly, rather than one who does them only occasionally alongside a broader practice. You deserve the expertise of a dedicated specialist.

Our Preferred Approach: Mini Back Scope Adrenalectomy (MBSA)

At the Carling Adrenal Center, we are not just high-volume; we use the surgical technique that, in our experience, delivers the best results for most patients, and which we use in more than 95% of our operations: the Mini Back Scope Adrenalectomy (MBSA).

Feature

Mini Back Scope Adrenalectomy (MBSA)

Laparoscopic (Robotic) Trans-Abdominal (LTA)

Surgical Incision

3 tiny incisions (0.5-1.1 cm) in the back

Incisions through the front of the abdomen

Organ Disruption

Stays out of the abdominal cavity

Requires moving abdominal organs out of the way

Hospital Stay

Often just overnight or even same-day surgery

Usually one to three nights

Recovery Time

Days to a week for full return to normal activity

Longer, due to abdominal wall recovery and organ manipulation

Pain Level

Significantly less postoperative pain

Higher pain levels due to abdominal incisions

Best For

Most adrenal tumors; very large tumors or known adrenal cancers may need a different approach

In our view, best reserved for selected cases, such as very large tumors

Partial

Our preferred operation for adrenal-sparing (partial) adrenalectomy

In our experience, less well suited to adrenal-sparing (partial) adrenalectomy

This is our preferred operation for most patients, yet relatively few surgeons are trained in it. Many instead use the traditional Laparoscopic (Robotic) Trans-Abdominal Adrenalectomy (LTA), which, while minimally invasive, is an approach that requires working through the abdominal cavity, moving the bowel and other organs (liver, kidney, colon, pancreas, etc.) out of the way. This route is familiar from other abdominal operations, but in our view it is not the ideal operation for the adrenal gland.

MBSA: The Clear Advantages

The MBSA, or Posterior Retroperitoneoscopic Adrenal Operation, approaches the adrenal gland directly from the back, completely bypassing the abdominal cavity. This provides remarkable benefits that dramatically improve your recovery.

This technique is a testament to the fact that the best surgeon is one who can tailor the approach to your specific disease and anatomy, prioritizing the least invasive and most effective route. Because I perform all types of adrenal surgery, I can select the exact technique, MBSA, Trans-Abdominal, or even Open Surgery for very large cancers, that gives you the best chance for a complete cure and the fastest recovery.

Beyond the Scalpel: The Surgeon-Scientist Advantage

My commitment to adrenal care extends far beyond the operating room. My background is unique: I am both a highly skilled surgeon and a PhD-trained scientist specializing in the molecular and tumor genetics of endocrine tumors. My extensive research background, with publications in elite journals such as Science, Nature Medicine, and the New England Journal of Medicine, means I don't just treat your tumor; I understand it at the deepest cellular level.

This surgeon-scientist advantage provides two key benefits for you:

  1. Cutting-Edge Diagnosis and Treatment: I am constantly translating the newest research into clinical practice, ensuring you benefit from the most advanced diagnostic and surgical protocols available globally.
  2. Expert Pathology and Genetics: We have a deep understanding of rare genetic syndromes and complex tumor types, which is critical for accurate diagnosis and long-term surveillance.

Choosing a surgeon-scientist is choosing a doctor who doesn't just follow established protocols but is actively writing them. In 2025 alone I published:

The Full Team: A Center of Excellence

Adrenal surgery is complex, and the best care requires a unified, multidisciplinary team, not just a single doctor in isolation.
The Carling Adrenal Center is located within the world-renowned Hospital for Endocrine Surgery in Tampa, Florida. Here, we work alongside the leading experts in thyroid and parathyroid surgery, creating a powerful trifecta of endocrine surgical expertise.
When you come to the Carling Adrenal Center, you gain access to an entire team dedicated to your adrenal health:

  • Dedicated Adrenal Specialists: Our staff and doctors are focused entirely on adrenal disease.
  • Seamless Care Coordination: We manage every aspect of your care, from initial consultation and imaging review to your operation and post-operative follow-up.
  • Global Destination Care: We are accustomed to patients traveling from all over the world. Our team handles the logistics, providing you with peace of mind so you can focus on your health.

Your Path Forward: Ask the Right Questions

Finding the best surgeon for your adrenal tumor requires active participation and asking the right questions. When evaluating any potential surgeon, I urge you to ask these questions:

  • "How many adrenalectomies do you perform each year?" (The answer should be in the hundreds, not five or ten.)
  • "Do you perform the Mini Back Scope Adrenalectomy (MBSA)?" (If not, why?)
  • "Do you perform adrenal-sparing (partial) adrenalectomy?" (If not, why?)
  • "What is your training specifically in adrenal tumors, beyond general surgery?"
  • "What is your complication rate for this procedure?"

Do not let convenience or a local referral bias your decision. The difference between a high-volume, dedicated specialist and a general surgeon who occasionally performs an adrenalectomy can be the difference between a smooth recovery and a complicated one. My life’s mission is to offer every patient the best possible outcome. Patients travel to the Carling Adrenal Center from across the globe because they know that for an adrenal tumor, settling for anything less than a dedicated, high-volume expert is simply not an option. Your adrenal health is too important. We realize that not every patient can travel to Tampa but hope information here will help you make excellent decisions for your best health.

Dr. Tobias Carling, of the Carling Adrenal Center, is one of the world's leading experts in adrenal gland surgery. Dr. Carling has performed thousands of adrenal operations over his career, including more than 2,400 since January 2022 alone. Dr. Carling left Yale University in 2020 to open the Carling Adrenal Center in Tampa, Florida.

To discuss the details of your case with Dr. Carling and become his patient, fill out the new patient form and he will be in touch with you shortly.

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Author

Dr. Tobias Carling MD, PhD, FACS

Dr. Tobias Carling is a world-recognized endocrine surgeon and adrenal surgery expert, widely regarded as one of the highest-volume adrenal surgeons in the United States and globally. He is the Founder and Surgeon-in-Chief of the Carling Adrenal Center in Tampa, Florida, an international referral center dedicated exclusively to adrenal tumors and adrenal hormone disorders. Prior to founding the Carling Adrenal Center, Dr. Carling spent 17.5 years at Yale University School of Medicine, where he served as Chief of Endocrine Surgery, Associate Professor of Surgery, Endocrine Surgery Fellowship Director, and Founder of the Yale Endocrine Neoplasia Laboratory. His work helped advance the understanding and treatment of adrenal, thyroid, and parathyroid tumors. Dr. Carling specializes in advanced minimally invasive adrenal surgery, including complex and function-preserving adrenalectomy techniques. He holds both an MD and PhD from Uppsala University in Sweden and has published extensively in leading scientific journals, including The New England Journal of Medicine, Nature, Science, and PNAS. He is a Fellow of the American College of Surgeons (FACS) and a member of the American Association of Endocrine Surgeons and the International Association of Endocrine Surgeons. Patients from across the U.S. and around the world seek his expertise for complex adrenal disease.