Endocrine Surgery 1.734.936.5818 Text Size
Search

About Your Adrenal Gland Surgery

Before Your Operation

A preoperative clinic visit will include:
  1. A History and Physical (H & P) Examination:
    It is important to know your full health history and any and all of the medicines you take. Depending on your other medical problems, you may need to be seen by another specialist before your operation.
  2. Bloodwork and Tests: According to your age, medical condition, and the type of surgery planned, you may be asked to have an EKG (heart tracing), chest x-ray, or blood work before your surgery.
  3. Instructions for You and Your Family: We will explain what to expect on the day of surgery and answer any questions that you may have, including:
    • Where to park
    • What to bring
    • When and where to arrive
    We will also give you written information with maps and phone numbers. A doctor will explain the surgery and you will be asked to sign a Consent to Surgery form.
  4. Anesthesia Evaluation: The anesthesiologist will see you on the morning of surgery if you are generally in good health. If you have any serious medical conditions, then you will also be seen by an anesthesiologist when you are in the Preoperative Clinic. Your record is then reviewed and the type of anesthesia is planned in advance.

How Long Will I Be in the Operating Room?

You will be in the operating room for about 2-4 hours with at least another 1-2 hours in the recovery room afterwards.

After Your Operation

How Long Will I Be in the Hospital?

Your hospital stay will depend on the method and extent of your surgery. If you need an open operation, you may be in the hospital for 5-10 days. If you undergo a laparoscopic adrenalectomy, you will likely be ready to go home in 1-2 days.

What should I expect after my surgery?

  • Your recovery will depend on the why you had surgery, the type of surgery, and your previous activity level.
  • Most people need about 3-6 weeks or more before feeling like they are back to normal. Recovery will be shorter for those undergoing laparoscopic adrenalectomy (several small incisions)and longer for those undergoing open adrenalectomy (one longer incision).
  • If you had a laparoscopic procedure, you may experience shoulder pain after surgery. This should resolve fairly quickly, but may last for 2-3 weeks.
  • It is not unusual to experience a decrease in your appetite, tiredness, or poor sleep during this timeframe.
  • It is not unusual to experience a decrease in your appetite, tiredness, or poor sleep during this timeframe.
  • You may feel a firm 'healing ridge' directly under the incision. This is normal and will soften over time.
  • All incisions are sensitive to sunlight. You should use sunscreen when the incision is exposed to sunlight to prevent darkening of the scar.
  • We recommend that you not expose the incision to ultraviolet lights used in tanning salons.

How will I manage my pain at home?

  • NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve) or acetaminophen (Tylenol) are most helpful for pain experienced after surgery
  • To prevent overdosing on acetaminophen, do not take it at the same time as a combination narcotic medication that contains acetaminophen, such as Vicodin or Norco. You may, however, take them 4-6 hours apart.
  • A prescription for stronger pain medications or narcotics (such as Vicodin or Norco) will be given to you. This medication will be tapered off over the next couple of weeks as you recover. do NOT drive a car or drink alcohol while taking these medications.
  • Narcotics can cause constipation. Stool softeners (Colace), fiber (fruits, bran, vegetables), and extra fluid intake may help. A stimulant laxative (Milk of Magnesia, Senokot) may be needed as well.

How do I care for my incision?

  • Your incision site(s) may be sensitive, so wearing loose clothing may be more comfortable. Avoid wearing tight restrictive clothing.
  • If you had a laparoscopic procedure, you may remove your plastic dressing 2-3 days after surgery. Under the plastic dressing, you may have strips of tape ("steri-strips"); leave them in place until they begin to fall off naturally. If they become discolored or messy, you may remove them 7-10 days after application.
  • If staples were used to close your incision, leave them in place. They will be removed by your home care nurse or in the clinic during a follow-up visit. They are usually removed 7-14 days after surgery.
  • Unless instructed otherwise, after 48 hours you may gently wash your incision with soap and water using a clean cloth. Use a clean towel afterward and gently pat the incision to dry.
  • You may shower but do not take a bath or get in a hot tub or swimming pool until your surgeon tells you it is okay to do so.
  • Do NOT apply ointments or powders to your Incision(s) unless directed to do so by your doctor.
  • Avoid smoking. It prevents proper wound healing.

Are there any diet restrictions?

  • No. Always eat a well-balanced diet, unless directed otherwise by your physician.
  • You may find your appetite is decreased at first, but it will improve as you recover. You may find eating smaller frequent meals will maintain your nutrition status.
  • Make sure to stay well hydrated.
  • Nutritional supplements such as Boost or Ensure may also be used to increase caloric intake.

What new medications might I need at home?

  • If you have had both adrenal glands removed, or if your remaining adrenal gland is not expected to function properly, you may receive steroids (hydrocortisone and/or florinef) to replace the hormones previously made by your adrenal gland(s). It is mandatory that you never stop taking these because the medication may be essential for life depending on the procedure performed. You need to contact your doctor before changing or omitting a dose.
  • You will need to purchase a medic alert bracelet stating "I have had an adrenalectomy. In case of emergency hydrocortisone may be lifesaving".
    You may enroll in Medic Alert by phone:
    1-800-432-5378 or you can check the Medic Alert web page for ordering information.
  • Inform all health care providers of your operation, especially in case of injury or surgery.
  • Carry extra doses of hydrocortisone with you for emergency use, especially when you travel.

When can I resume normal activities?

  • Walk as much as possible. Gradually increase the length of time and the distance that you walk.
  • You may climb stairs.
  • Do not drive until you are no longer taking narcotics and your activity level is back to normal.
  • Do not lift, pull or push anything greater than 10 pounds (10 pounds = about a gallon of milk) for 4 weeks or as directed by your physician.
  • Avoid activities that would make you tense or strain your abdominal muscles for 4 weeks or as directed by your physician. These activities may include twisting or vacuuming.
  • You may resume all other normal activities as soon as you feel up to it.

Can I resume my previous medications?

  • Yes, unless directed not to by your doctor.
  • Before discharge, be sure to review your previous medications with your doctor or inpatient medical team.

When do I call for advice?

  • Most patients have no problems after surgery, but if you are concerned, please do not hesitate to call us.
  • Call if you develop a fever greater than 101.5 degrees Fahrenheit.
  • Call if you have difficulty breathing or note yellow sputum production when you cough.
  • Call if your incision becomes red or begins to drain fluid.
  • Call if you have difficulty urinating and feel like you aren't emptying your bladder fully.
  • Call if you begin feeling worse several days after surgery rather than better.
  • Call if you are discharged with a drain and the site becomes red, swollen, or you have a great change in the amount of drainage (more or less).
  • Call if you are unable to eat or drink, have ongoing nausea or vomiting, or your abdomen becomes significantly distended and you can't pass gas or have a bowel movement.
  • Call if you experience extreme fatigue, weakness, weight loss, dizziness, muscle cramps, or faint.
  • Contact the Call Center at 734-936-5818 and ask for the Endocrine Surgery Nurse Coordinator (Monday – Friday, 8am - 4pm)
  • On weekends, holidays, or evenings call 734-936-6267 (hospital paging) and ask for the General Surgery Blue team resident-on-call. You may also call the main hospital number (734) 936-4000.

When will I see my surgeon again?

  • You will be scheduled to for a return visit in the Endocrine Surgery clinic about 2 weeks after surgery.
  • The clinic nurse coordinator will call you 1-3 days after your discharge to see how you are feeling.
  • If blood tests have been requested at the time of your return visit, please remember to go to the lab before you check in for your appointment. Take your lab requisition form with you and allow 15-20 minutes to have your blood drawn.

Other Resources

University of Michigan Endocrine Surgery Website

Risks of Adrenal Surgery

General Risks of Any Operation

Modern surgery is quite safe, but always entails some risk. Surgical complications are more likely in the elderly or in people with serious medical illnesses. Please inform your surgeon if you have previously had any of the following problems or believe you may be prone to them.

General risks of undergoing an operation include:

  • Heart and circulation problems such as heart attack or blood clot formation. Clots which form in the legs can move to the lungs and cause life-threatening problems. Blood clots or debris can similarly cause a stroke.
  • Bleeding during the operation is a possibility as the adrenal glands are adjacent attached to large arteries and veins. The need for blood transfusion is a possibility especially in operations done for large cancers of the adrenal gland.
  • Abnormally high or low blood pressure is a risk following removal of certain adrenal tumors and can usually be prevented or treated with medicine.
  • Wound infections are not common, but may be more likely in people with diabetes or steroid therapy.
  • Other infections such as bronchitis, pneumonia, or urinary infections can develop after a general anesthetic and operation.
  • Any surgical incision in the abdomen may be at risk of developing a hernia long after the operation.
  • Depending on the type of adrenal disorder leading to your adrenalectomy, you may require oral steroid medication to replace those steroids formally made by the adrenal gland. In some cases, these steroids are essential for life.
For appointments, please call 734.936.5818
The Priority Parathyroid Program