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What Happens During Robotic Adrenalectomy: Understanding the Role of Micro Cuts and Ports?

30 Apr
By Dr. Anup Ramani

The field of adrenal gland surgery in India has advanced significantly in recent years, particularly with the introduction of robotic systems. One of the defining features of this modern approach is the use of micro cuts and ports, which are central to the success and safety of the surgery.

In Mumbai, a leading center for robotic surgical procedures, patients undergoing adrenal gland surgery often benefit from this minimal invasive technique. This guide provides a practical understanding of how these micro incisions and specialized ports contribute to a smoother surgical process and a faster recovery.

What is Robotic Adrenalectomy?

Robotic adrenalectomy is a procedure to remove one or both adrenal glands using a robotic system. This method replaces traditional open surgery with a more refined, minimal invasive process. It may be used to treat conditions like adrenal tumors, hormone imbalances and cancers affecting the adrenal gland.

Instead of one large incision, the surgeon makes small openings – known as micro cuts – through which instruments are inserted using ports. This allows for more accurate movement inside the body with fewer complications.

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Why Micro Cuts are used in Robotic Adrenal Gland Surgery?

Micro cuts are small incisions, typically around 3 mm in size, made in the abdomen. They are necessary for placing ports that serve as pathways for the robotic instruments and camera. In adrenal gland treatment, usually three such micro cuts are made.

The Advantages of Micro Cuts May Include:

  • Minimal tissue damage
  • Less postoperative pain
  • Shorter hospital stays
  • Smaller and less visible scars
  • Faster return to normal activities

These tiny openings help reduce overall trauma to the body and support a quicker recovery compared to larger surgical incisions used in open surgery.

The Role of Ports in Robotic Surgery

After the micro cuts are made, ports are inserted into these incisions. A port is a small tube that allows the robotic arms and camera to enter the body. Each port serves a specific purpose:

  • One port may be used for the camera, which sends real-time images to a screen.
  • Other ports hold the instruments used to perform the surgery.
  • An extra port may be added if the assistant surgeon needs access.

These ports are essential for maintaining a clear, stable entry for the robotic tools. Their placement is carefully planned before surgery based on the patient’s anatomy. The goal is to provide the best possible angles for visibility and instrument movement.

How Robotic Adrenalectomy is Performed Using Micro Cuts and Ports?

Once the patient is under general anesthesia and positioned on the operating table, the process begins:

  • Three micro cuts are made, each about 3 mm wide.
  • Ports are inserted into these cuts to create controlled access.
  • The robotic system is connected to the ports.
  • The surgeon operates from a console, viewing a high-definition image from the internal camera.
  • Robotic arms perform the surgery, carefully detaching the adrenal gland.
  • The gland is removed through one of the ports using a small bag.
  • A drain tube may be placed to remove fluid.
  • A catheter is placed during surgery and removed after recovery begins.

This entire process usually takes about an hour. The robotic instruments allow for delicate movements that may not be possible with the human hand alone, especially in tight or complex spaces.

Recovery After Surgery: What Patients Can Expect?

Because the surgery involves only a few micro cuts, patients generally recover quickly. After the procedure:

  • Patients may not eat on the first day and will receive fluids through an IV.
  • Water is often allowed by the next day.
  • Solid food is introduced on the third day.
  • The drain, if used, is usually removed on Day 2.
  • The urinary catheter is also typically removed on Day 2.
  • Most patients are discharged within 2 to 3 days.

The use of micro cuts and ports helps reduce healing time, which is especially important for those needing to return to work or daily routines quickly.

Why Adrenal Gland Surgeon Experience Matters?

While robotic systems enhance precision, the experience of the surgeon is critical. Correct placement of ports and effective handling of instruments requires detailed planning and a deep understanding of the procedure.

An experienced robotic adrenalectomy surgeon in India can ensure:

  • Accurate port placement
  • Safe tissue dissection
  • Avoidance of complications
  • Smooth post-surgical recovery

For Adrenal Gland treatment in Mumbai, Dr. Anup Ramani offers many advanced surgical treatments perform adrenal gland surgeries, increasing the likelihood of better outcomes.

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Conclusion

In adrenal gland surgery, the size and placement of cuts matter more than ever before. Micro cuts and ports are not just minor technical details – they are the foundation of safer, cleaner and faster robotic adrenal surgeries.

FAQs About Robotic Adrenalectomy

Micro cuts are very small incisions, usually around 3 mm, used to insert ports during robotic adrenalectomy.

Ports provide stable access for robotic tools and cameras, allowing the surgeon to perform the procedure safely and accurately.

The surgery typically takes about one hour, depending on the complexity of the case.

Scars from micro cuts are usually small and may fade over time. They are much less noticeable than those from traditional surgery.

Most patients are discharged within 2 to 3 days after surgery, depending on recovery.

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Dr. Anup Ramani is one of the best Uro oncologist, Surgeon in Mumbai, India providing Robotic Surgery and Treatment for Prostate Cancer, Kidney Tumor Surgery/Stone Removal, Urinary Bladder Cancer and Adrenal Gland Treatment, Enlarged Prostate Surgery and treatment, Penis Cancer/Partial Penectomy/Robotic Pyeloplasty Surgery and Treatment.

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PARTIAL PENECTOMY
  • Partial penectomy is done in cases where glans and distal penis is involved with carcinoma. 
  • Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
  • Patients who develop stones in the kidney or ureter, often experience severe pain.
  • This condition usually needs a procedure to remove the kidney stones.
  • This procedure is called ureteroscopy and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
  • The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
  • The procedure takes about 40-50 minutes. 
  • A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is one night and patient is discharged the next day after removal of the catheter.
  • Patient has to come back after six weeks to remove the stent in the kidney.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
  • Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
  • This procedure is called TURP and is performed very commonly.
  • It does not require any cuts and hence it is painless.
  • The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
  • The overgrown prostate is dissolved with a laser bloodlessly.
  • The procedure takes about 40 minutes.
  • A catheter (urine pipe) is kept after the procedure to drain the bladder.
  • Patient is mobile and walking in the room the same evening.
  • Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
  • Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
  • We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR

  • Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.

  • Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.

  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).

  • Dr. Ramani then sits in the controlling console to perform the surgery.

  • On an average, a robotic adrenalectomy takes one hour.

  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.

  • A urine catheter and bag to drain the bladder is inserted during surgery.

  • A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.

  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.

  • The drain pipe, if kept, is removed in the room on day 2 after surgery.

  • The catheter is removed on day two after surgery.

  • Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).

  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.

RETURN TO ACTIVITY

  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.

  • Heavy activities like running, weight lifting can be resumed after a month

FOLLOW UP AFTER SURGERY

  • Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
    Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consultation.

ROBOTIC SURGERY FOR BLADDER CANCER
  • Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
  • Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
  • Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the new bladder is inserted during surgery.
  • Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
  • The drain pipes are removed in the room on day 3-5 after surgery.
  • Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
  • Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY

  • Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.

  • Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.

  • Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.

  • If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.

ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
  • Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
  • relatively easier but still requires significant experience to consistently deliver results.
  • Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
  • The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
  • Dr. Ramani then sits in the controlling console to perform the surgery.
  • On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
  • The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
  • A urine catheter and bag to drain the bladder is inserted during surgery.
  • A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
  • Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
  • The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
  • Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
  • Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
  • On the day of discharge, patient is totally self- sufficient. 
  • They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. 
  • Almost all patients are back to work within 2-3 weeks of surgery.
  • Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
  • Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
  • Local patients usually meet Dr. Ramani after two weeks to discuss report. 
  • Outstation patients are counselled on a phone consultation.