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Adrenalectomy: what the operation involves | CION Cancer Clinics
An adrenalectomy removes one adrenal gland, the small hormone-making gland above the kidney, while you are fully asleep. Most are done by keyhole surgery through the belly or the back, and most people are walking the next day. This page walks through the operation from admission to the pathology report, and says what it cannot decide for you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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The short answer
What happens during an adrenalectomy?
An adrenalectomy is an operation to remove one adrenal gland, the small hormone-making gland that sits on top of each kidney. You are fully asleep under a general anaesthetic, the surgeon reaches the gland through small keyhole cuts or one larger cut, seals its blood vessels, and lifts the whole gland out with the tumour inside it.
Why the whole gland comes out
Adrenal tumours are almost never cut out with the rest of the gland left behind. The gland is small, its blood supply is delicate, and the tumour is safer removed unopened inside its own capsule. Because you have two adrenal glands, the one that stays usually takes over the work of both.
Who this page is for
This page describes the operation itself, from the anaesthetic room to going home, for the person having it and for the family member waiting outside. It does not decide whether you need the operation. That is answered by your own surgeon and endocrinologist, who have your scans and hormone tests in front of them.
If your tumour is a phaeochromocytoma, the weeks before the operation matter as much as the operation. Ask your team about medicine preparation early.On the day
What actually happens, from arrival to the ward
Admission and checks
You come in fasting, as instructed. A nurse checks your blood pressure, pulse and sugar. The anaesthetist confirms which medicines you took that morning, and your family is told roughly how long to expect.
Going to sleep
A drip is placed in your hand and the anaesthetic is given through it. For adrenal surgery the anaesthetist often also places a thin line in an artery at the wrist, so blood pressure can be read beat by beat rather than every few minutes.
The operation
Most adrenal glands are removed by keyhole surgery, through the belly or the back. The surgeon frees the gland from the kidney, seals the adrenal vein, and lifts the gland out in a bag through one of the cuts.
Recovery room
You wake with a nurse watching your blood pressure and pain. Some people go to a high-dependency bed for the first night, especially after a hormone-producing tumour. That is planned, not a sign of trouble.
Back on the ward
Sips of water the same day, walking with help the next morning, and a check of your blood pressure and sugar levels before anyone talks about going home.
Not sure whether this applies to you?
Ask an oncologistThree routes to the gland
Which way will the surgeon go in?
All three reach the same gland. The choice depends on the size of the tumour, whether it looks like a cancer, and what your surgeon does most often.
Keyhole through the belly
Several small cuts on the front or side of the abdomen, a camera and long instruments. This is the most widely used route in India and gives the surgeon a clear view of the surrounding organs.
Usually chosen for
- Small and medium non-cancerous tumours
- Hormone-producing tumours that are not very large
Keyhole through the back
You lie face down and the surgeon reaches the gland directly from behind, without entering the abdominal cavity. Recovery is often quick, but the working space is small, so it suits smaller tumours.
Often considered when
- You have had abdominal surgery before
- Both glands need attention
Open surgery
One longer cut under the ribs or down the middle. Used when the tumour is large, when the scan suggests an adrenal cancer that may be growing into nearby tissue, or when keyhole surgery has to be converted mid-operation for safety.
Converting to an open cut during keyhole surgery is a safety decision, not a failure.Afterwards
How long does it take to recover?
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The first night
Blood pressure, pulse and sugar are checked often. After a hormone-producing tumour the pressure can drop once the gland is gone, so fluids and sometimes a drip medicine are adjusted through the night.
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The first few days
After keyhole surgery most people are eating, walking and managing on tablet painkillers within a day or two. Shoulder-tip pain from the gas used in keyhole surgery is common and settles on its own.
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Going home
You leave with a list of medicines, a wound-care sheet and a date to return. If you have been started on steroid tablets, you will also leave with instructions on what to do if you are vomiting or unwell, because missing those tablets can be dangerous.
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The following weeks
Light work and driving usually come back within a few weeks, once you can move freely and are off strong painkillers. Heavy lifting waits longer, and longer still after an open cut.
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The pathology appointment
The removed gland goes to the laboratory. The report, usually ready in a week or two, tells your team whether the tumour was benign or a cancer and whether any further treatment or follow-up scans are needed.
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Commonly believed
Four things families ask us, and what is actually true
"Once the gland is gone, I will be on tablets for life."
Usually not. When one gland is removed, the other one normally takes over. Lifelong tablets are needed when both glands are removed. A temporary course is sometimes needed after a cortisol-producing tumour, while the remaining gland wakes up.
"Keyhole surgery means the tumour was not serious."
The route is chosen on size and scan appearance, not on how worried the team is. The pathology report, not the size of the scar, tells you what it was.
"It is a small gland, so it is a small operation."
The gland is small, but it sits deep, next to the kidney and large blood vessels, and it pours hormones into the blood while it is handled. That is why an anaesthetist experienced in adrenal surgery matters as much as the surgeon.
"My father can stop his blood pressure tablets straight after."
Do not stop or change any tablet on your own. Some people need fewer blood pressure medicines after the gland is removed, but the change is made step by step by the treating doctor, using readings taken at home and at follow-up.
Being straight with you
What this page cannot tell you
This page cannot tell you whether you need the operation, which route is right for you, or whether the lump is a cancer. Those answers come from your hormone tests, your scans and the surgeon who will do the operation.
Questions worth taking to the surgeon
Ask which route they are planning and why. Ask how many adrenal operations their team does in a year, and whether an anaesthetist who regularly handles hormone-producing tumours will be in the room. Ask what would make them convert to an open cut, and whether you will need steroid tablets afterwards, even for a short while.
Who the operation does not suit
Not every adrenal lump needs removing. Small lumps found by chance that make no hormone are often watched with repeat scans instead. Very large cancers growing into neighbouring organs may need a wider operation than an adrenalectomy alone. And a person too unwell for a general anaesthetic may be offered medicines to control the hormone instead. None of those decisions is made from a web page.
Bring every scan and hormone report to the first visit, including tests done at another hospital. They are rarely repeated if the originals are in hand.Questions we are asked
Common questions about adrenal surgery
How long does the operation itself take?
Usually a couple of hours from going to sleep to arriving in recovery, though the family may wait longer because of preparation and handover. A large tumour, an open cut or a hormone-producing tumour that needs careful blood pressure control can all add time. Ask the team for an estimate on the day.
Will I be in the ICU afterwards?
Sometimes, and it is usually planned in advance. After a phaeochromocytoma or a large cortisol-producing tumour, a high-dependency bed for the first night lets the team watch blood pressure and sugar closely. After a simple keyhole removal many people go straight back to the ward.
How many cuts will I have, and where?
Keyhole surgery through the abdomen usually leaves three or four small cuts on the side of the belly. The back approach leaves them below the ribs on the back. Open surgery leaves one longer scar under the rib cage. Your surgeon can show you where before you sign the consent form.
Can the other adrenal gland really do the work of two?
In most people, yes. The remaining gland makes enough cortisol, aldosterone and adrenaline for normal life. The exception is after a tumour that has been over-producing cortisol, which can leave the other gland sleepy for a while. In that case you are given steroid tablets until blood tests show it has recovered.
Will I need to change what I eat afterwards?
No special diet is needed after removal of one gland. Eat normally as soon as you feel like it, drink well, and keep your fibre up because painkillers can cause constipation. If you have been put on steroid tablets, take them as instructed and never skip them when unwell without calling your team.
When can I go back to work and drive?
After keyhole surgery, desk work and driving usually return within a few weeks, once you can twist and brake without pain and are off strong painkillers. Physical work waits longer, and longer again after open surgery. Ask your surgeon for a timescale for your job, and say if you drive for a living.
Is the tumour tested after it is removed?
Always. The whole gland goes to the pathology laboratory and is examined under the microscope. The report says what kind of tumour it was, whether it was benign or a cancer, and whether the outer capsule was intact. That report, not the scan, decides whether you need further treatment or follow-up.
Is adrenal surgery covered by Aarogyasri or insurance?
Often, when it is part of an approved treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Pre-approval rules differ by scheme, so call the helpline with your card details and the surgeon's plan before you fix a date.
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Sources
- Cancer Research UK — Surgery for adrenal gland cancer
- National Cancer Institute — Adrenocortical Carcinoma Treatment (PDQ) - Patient Version
- Cancer.Net (ASCO) — Adrenal Gland Tumor: Types of Treatment
- NHS — Phaeochromocytoma
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Why an Adrenal Gland Is RemovedThe reasons a team recommends the operation at allLaparoscopic vs Open AdrenalectomyHow the route to the gland is chosenSteroid Replacement After Adrenal SurgeryWhen tablets are needed and for how longThe Day of the OperationWhat every cancer operation day looks likeAnaesthesia for Cancer SurgeryWhat the anaesthetist does before and during
Talk to us
Been told you need an adrenal gland removed?
Send us your scan and hormone reports or call the helpline. A surgical oncologist will explain what the operation would involve in your case. One helpline serves every CION centre.