What to Expect After Adrenalectomy (Adrenal Gland Surgery)?

The adrenal glands are two small, triangular-shaped glands located on top of each kidney. Their outer layer, the adrenal cortex , produces hormones such as cortisol. These hormones influence the body's salt and water balance , stress response , metabolism , the immune system , and sexual development and function .

The inner layer, the adrenal medulla , produces hormones such as epinephrine (adrenaline). Adrenaline increases blood pressure and heart rate when the body is under stress.

Operation

Tumors in the adrenal glands can be cancerous or can lead to excessive hormone production in the body. This can cause problems such as high blood pressure, increased heart rate, excessive sweating, and fatigue .

In most patients, the adrenal gland can be removed laparoscopically (through small incisions in the abdomen or back). However, some patients may require open surgery to remove the gland, which involves an incision 7.5–23 cm (3–9 inches) long.

Depending on the amount and quantity of excess hormones released after surgery, you may need to stay in the hospital for 1-3 days. We will inform you about this before the surgery.

How will I feel after the surgery?

• Your throat may hurt when you swallow. This is normal and may last for 1-2 days .

• Your voice may become hoarse or you may feel that your voice tires easily. These changes may last for 1–2 weeks .

• You may experience shoulder pain due to gas injected into your abdomen during surgery. To relieve the pain, lie on your back and place a few pillows under your hips. Stay in this position for 5–15 minutes . The gas pain will subside over time. This condition is more common in laparoscopic surgery than in retroperitoneal surgery performed through the back.

  
  

Wound Care

Check your wound daily and watch for signs of infection.

• Widespread redness or swelling

• Foul-smelling discharge or inflammation

• An oral temperature above 38°C

Your wound has been closed with dissolving stitches. Small bruises at the incision site are normal.

General Precautions

• Do not lift more than 9 kg during the first week.

  • Restrictions after laparoscopic surgery typically last 1–2 weeks .

  • If the incision is 7.5–23 cm, it takes 4–6 weeks .

• Avoid strenuous activities involving pulling, pushing, or twisting until permission is granted.

• Walking is allowed and recommended.

• Do not swim or stay in the water for 14 days .

• You can shower after 2 days.

• Avoid rubbing the incisions until they are completely healed (usually about 2 weeks ).

• You can resume sexual intercourse when you feel ready; this is usually 2–3 weeks after surgery.

  
  

Pain

Tenderness at the incision site is expected. You will be prescribed pain medication to use at home. Please do not hesitate to use it.

Applying ice to the incision site can reduce pain and swelling.

Constipation can occur after surgery. To prevent this:

• Drink plenty of fluids and eat fiber-rich foods.

• Drink 8–10 glasses (200 ml) of fluid per day.

• Consume at least four servings of fruit or vegetables .

• Consume at least 2–4 servings of whole-grain bread or grain products .

• You can use an over-the-counter stool softener if needed.

  
  

When should you go to the emergency room?

• Pain that doesn't go away despite taking painkillers.

• Signs of infection: increased redness, rising temperature, bloody or purulent discharge.

• A fever above 38°C in two temperature readings taken 4 hours apart.

• Any other symptoms that worry you

Although rare , call 112 if you experience shortness of breath, sudden swelling in the throat, difficulty swallowing, or uncontrolled bleeding.

Control (Monitoring)

You must come for a follow-up appointment on the date given to you after the surgery. During this appointment, the incision sites and your general condition will be evaluated. Since the pathology results take approximately one week, we can discuss the results when you come at the clinic.

If your adrenal gland was removed due to excess hormones causing high blood pressure , you will be asked to monitor your blood pressure at home. Measure your blood pressure at least once a day, after resting for a few minutes, keep a record, and bring it to your follow-up appointment.

If your adrenal gland was removed due to excess steroid hormones , you will most likely be discharged on steroid medication . This medication should not be stopped abruptly . The steroid dose will be gradually reduced after the function of the remaining adrenal gland is assessed.

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