Adrenal Surgery Information

What Will Be Done Before The Operation?

A Preoperative Clinic Visit Will Include:

1. A History and Physical 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 report
   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.

What Can I Expect After The Operation?

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.

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.

After Your Operation

• You will have a call light handy - let the nurse know if you need something!
• It is normal to feel tired, groggy and weak from the effects of anesthesia. Do not get out of bed by yourself! Ask for help.
• When you are steady, you will be encouraged to sit and walk frequently. Time out of bed aids your recovery.
• You will have pain medicine available to relieve your discomfort. This is usually given intravenously or orally depending on the operation and the level of discomfort.
• You will receive ice chips to start and then be given a clear liquid diet such as Jello or tea. You will progress onto regular food. The speed of this progression depends mostly on the method of adrenalectomy.
• You may shower as usual after about 24-36 hours. The incision(s) may be gently washed, not scrubbed, with mild soap and water. Pat the area dry.

What Will I Need To Know To Go Home?

• A nurse will review discharge instructions with you and give you written information to take home.
• You will be scheduled to see your surgeon in 1-3 weeks after your operation. This will be in the same clinic in which you were seen before your admission (Taubman Center / Reception Area F).
• When you leave, your wound will be covered by paper "Steri-Strips^TM" which will remain in place until your post-operative clinic visit. If they become unsightly or bothersome to you, you may remove them 10 days after your operation.

How Long Does It Take For My Incision To Heal?

• Your incision(s) will be watertight in about 24-36 hours allowing you to shower carefully. The incision normally heals fully within a few weeks. There is also swelling and a feeling of firmness under the incision that may last for a couple of months. If you have surgical staples closing your wound, these will be removed by 14 days after your operation.
• Most scars are most noticeable 1 - 2 months after operation and gradually become less so after several months. Until that time, you may notice the color is more red than surrounding skin. This is normal and will improve.
• Depending on the method of your adrenalectomy, your incision will also involve a variable amount of muscle. This also takes a few weeks to heal and should not be strained. Your surgeon will give you specific recommendations about activity and weight lifting limits.

What Are The 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.