Having your adrenal gland removed

This leaflet explains the operation to remove one of your adrenal glands. (The human body has two adrenal glands). This operation is sometimes called an 'adrenalectomy’. 

We perform this surgery to remove an adrenal gland because:

  • it contains benign (non-cancerous) tumours 
  • we suspect, or have confirmed, that it is cancerous.

The operation usually takes 2 to 3 hours.

We perform it while you are under a general anaesthetic. This means you are asleep throughout the operation.

We will give you more information about the anaesthetic at your pre-operative assessment appointment. 

About robot-assisted surgery

We perform this operation using keyhole (laparoscopic) surgery with robotic assistance. 

Keyhole surgery means we insert a telescope and other instruments into your body through small cuts (instead of one large cut).  

Robot-assisted surgery means the surgeon uses the robot to help perform the procedure. The robot does not operate by itself. It allows the surgeon to make more precise movements and do more complex surgery.

Read our leaflet to learn more about robot-assisted surgery and why we use a robot.

Benefits of this type of surgery 

Keyhole surgery uses only a few small cuts (each about the size of your fingertip). Sometimes we may need to make a larger cut, depending on the situation.

This means that robot-assisted keyhole surgery has many benefits, compared to traditional ‘open’ surgery.

Most patients go home the day after surgery, or within 1 to 3 days. 

You are likely to return to normal activities sooner after keyhole surgery. 

Other benefits of keyhole surgery include:

  • smaller scars
  • less blood loss
  • lower risk of infection
  • less pain
  • lower risk of wound complications.

What to expect

Before your operation

Before your surgery, you will have the following.

  • An appointment with the surgical doctors. They will explain the procedure and discuss the benefits and risks. 
  • A pre-operative assessment. This may include blood tests, heart checks and other tests. At this assessment, we will give you full instructions on how to prepare in the days leading up to your operation. These include whether to stop your medications, and when to stop food and drink. If you have other relevant medical conditions, you may see a consultant anaesthetist for more detailed checks.

On the day of surgery

On the day of surgery, we will admit you to the Kingston Hospital Admissions on the Day (AOD) Unit. If you have other health problems we may admit you the evening before surgery.

The anaesthetist will see you on the morning of surgery. The surgical team will also see you to obtain your consent for surgery. They will draw a mark on the area of your body where the surgery will take place.

We may decide to give you a spinal anaesthetic before we give you a general anaesthetic. This will make you numb (have no feeling) from the waist down during the operation. This lack of feeling will continue for 6 to 12 hours, and will help with your post-operative pain levels.

After the operation (in hospital)

After surgery, you may spend one night in a high-dependency unit, if needed.

We may give you:

  • an oxygen tube in your nose (which we usually take out after 1 day)
  • a drip in your arm (which we usually take out after 1 day)
  • a wound drain to remove excess blood and fluid (which we usually take out after 1  day)
  • a catheter (thin, flexible tube) to drain your bladder (which we usually take out after 1 day).

Driving

You will not be able to drive yourself home after this procedure. We advise you to arrange for someone to drive you home and stay with you overnight.

Eating and drinking

We will give you instructions about eating and drinking after your surgery. It is likely we will encourage you to drink and eat as you feel able. 

Pain

You may feel mild pain, swelling or bruising around the surgery cuts. 

You may get shoulder pain, due to the gas we use to inflate your abdomen during surgery. Your abdomen may feel bloated (swollen) or uncomfortable. These symptoms usually settle within a few days.

Getting moving

Our nurses or physiotherapists will help you to get out of bed and move around. If you can, do this first thing on the morning after your surgery. Gentle movement helps reduce complications and will speed up your recovery.

Going home

Most patients go home 1 to 3 days after surgery, depending on their recovery. 

You may have stitches that dissolve (fall out naturally) or wound clips. If you have wound clips, you will need to arrange for your GP practice nurse to remove them 10 to 14 days after surgery. 

Do not drive for 2 to 4 weeks after your operation. Only drive when you are not limited by pain and can react quickly enough to perform an emergency stop.

Recovery at home

You can expect the following while you recover at home.

Pain For most patients, their pain is often at its worst between day 2 and day 4 after the operation. Before you leave hospital, we will discuss appropriate pain relief with you. 
Washing  You can shower the day after your operation. Your surgery wounds will not need dressings.
Constipation Patients often feel constipated (unable to poo easily). We will give you medicines (laxatives) to use if you need them.
Tiredness You may feel tired for up to 2 months. This is normal.
Exercise

We recommend gentle walking and light exercise. This will speed up your recovery.

For 3 to 4 weeks, avoid heavy lifting, gym work, running, cycling or swimming.
Check your wounds

Check your wounds for signs of infection, such as redness, swelling, pain or discharge.

Contact your GP, district nurse or hospital team if you have any concerns.

When to seek urgent medical help

Go to your nearest Emergency Department (A&E) if you experience:

  • fevers or sweating
  • vomiting
  • a feeling of being extremely unwell (you feel something is seriously wrong with your health).

Risks of this operation

Risks during or shortly after surgery

Less common
Fewer than 15 in 300 patients
  • Switch from keyhole to open surgery during the operation. We may do this to control bleeding, repair intestinal injury or because we cannot complete the operation in the keyhole way. There is greater risk of this happening if you are obese or have had previous surgery in the same body area.
Rare
Fewer than 3 in 300
  • Significant bleeding caused by injury to blood vessels, liver or spleen. You may need a blood transfusion or further emergency treatment.
  • Damage to the bowel, liver, kidney, pancreas, spleen, stomach.
  • Complications during or immediately after the operation, such as infection, blood clots, heart problems, stroke, memory problems or kidney problems. These may mean you need to stay in hospital for longer or need extra treatment.

Risks after surgery

Common
More than 15 in 300 patients
  • Abdominal and shoulder tip discomfort is expected for a few days or weeks.
  • Bloating of the abdomen and slowing of the bowel and constipation. This usually resolves within a few days.
Less common
Fewer than 15 in 300 patients
  • Wound infection. This may need treatment, such as antibiotics.
  • Abdominal fluid collection. May need antibiotic treatment, drainage or a further procedure.
  • Blood clots. Wearing compression stockings and getting moving early reduces your risk of clots. We may also use blood thinning injections, depending on your treatment and medical history.
  • Hernia caused by the abdominal muscles being weakened by the surgery wound. Tissue, such as bowel, may bulge through. Patients sometimes need surgery to correct this.
  • Scarring.
Rare
Fewer than 3 in 300
  • Insufficient steroid hormones produced (usually compensated for by remaining adrenal gland).

Follow-up

We will invite you for a follow-up appointment 6 to 8 weeks after your procedure.

More information

Kingston Hospital information on robot-assisted surgery

Macmillan Cancer Support

Contact information

Kingston Hospital Urology Department

Telephone:

020 8934 2976

Email: krft.urology@nhs.net