Thyroid surgery is a well-established operation with a low overall complication rate. The usual hospital stay is a single night, which allows for assessment of the wound, voice, and calcium levels before discharge. Surgical drains are rarely required. Patients with significant co-morbidities, or those in whom the operation is anticipated to be technically complex, may be admitted to a high care unit for closer postoperative monitoring. This is a precautionary measure and is applied selectively.

The recurrent laryngeal nerves, which control the vocal cords, lie in close relation to the thyroid gland. Intra-operative nerve monitoring is used routinely to assist in identifying and preserving these nerves. Despite meticulous technique, some patients experience a change in voice after surgery, such as hoarseness, reduced projection, or vocal fatigue. These symptoms may reflect nerve irritation or the effects of the endotracheal tube used during anaesthesia. Most changes resolve within weeks to a few months. Permanent voice change is uncommon.

Following total thyroidectomy, the parathyroid glands, which regulate calcium, may temporarily under-function, resulting in hypocalcaemia. This typically presents with perioral or fingertip tingling, or muscle cramping. Calcium levels are monitored after surgery, and the condition is managed effectively with calcium and, where necessary, vitamin D supplementation. In the majority of patients parathyroid function recovers and supplementation can be discontinued. A small proportion require long-term treatment. Patients who develop these symptoms after discharge should take their prescribed supplements and contact the rooms.

Wound haematoma is an uncommon complication, but it requires prompt recognition because neck swelling can compromise the airway. It generally occurs within the first 24 hours, which is a principal reason for the overnight stay. Patients who notice rapid neck swelling, tightness, or difficulty breathing should alert the nursing staff immediately. The risk of wound infection is low. Individual risk varies with the indication for surgery, the extent of the operation, and the patient’s general health, and these factors are discussed in detail at the pre-operative consultation.

Most patients are discharged on the day after surgery, and before you leave the nursing staff and I will explain how to care for yourself at home. For the first 24 hours after the anaesthetic you should not drive or operate machinery, make important decisions or sign legal documents, or drink alcohol. Your regular medications should be taken as instructed. Pain is usually mild to moderate and is most noticeable when swallowing, so it is helpful to take your pain medication about 30 minutes before meals. Simple analgesics such as paracetamol, with or without an anti-inflammatory such as ibuprofen or naproxen, are often sufficient, and stronger medication will be prescribed if required. If you are given an opioid-containing analgesic, constipation is common, and a stool softener may help. Depending on the extent of your operation, you may also be prescribed thyroid hormone replacement, which is taken daily, and calcium supplements, which are used to prevent or treat a low calcium level.

For the first few days a soft diet, such as soup, eggs, yoghurt, or puréed foods, will be more comfortable than hard or dry foods. Sleeping with the head and shoulders raised for about a week reduces swelling in the neck. A cold pack, wrapped in a thin towel and applied to the area for about 15 minutes every one to two hours, may relieve discomfort and swelling. The wound should be kept dry and covered for the first one to two days, after which it may be washed gently with soap and water in the shower and patted dry. It should not be submerged in a bath, pool, or the sea until it has healed completely. Please wash your hands before and after touching the wound or dressing, and do not pick at glue or tape, which will separate on its own. Activity should be increased gradually, starting with short walks around the home. Heavy lifting, strenuous exercise, and swimming should be avoided for at least one to two weeks, and I will advise you on this individually.

I will review you after the operation to assess your recovery and to discuss the pathology results. If non-absorbable sutures or staples have been used, these are usually removed after one to two weeks. Depending on your diagnosis and the extent of the surgery, I may also arrange for you to be seen by an endocrinologist, who will assist with your thyroid hormone replacement.

Please contact my rooms for advice if you develop a temperature of 38°C or higher, or chills; redness, discharge, or increasing swelling at the wound; numbness or tingling around the lips or in the fingers, or muscle twitching or cramps, which may indicate a low calcium level, in which case you should take your calcium as instructed while you wait to speak to us; difficulty moving the lips or opening and closing the mouth; or nausea and vomiting persisting for more than two days after discharge. Rapidly increasing swelling of the neck, or any difficulty breathing, swallowing, or speaking, requires urgent attention, and you should go to the nearest emergency unit immediately and not wait for a return call.

Parathyroid surgery is performed to remove the overactive gland or glands responsible for hyperparathyroidism. In a proportion of patients with primary hyperparathyroidism, pre-operative imaging localises the abnormal gland with sufficient confidence to permit a limited, focused exploration through a small incision. Other patients, including those in whom imaging is inconclusive or in whom more than one gland is suspected to be involved, require a bilateral exploration, in which all four glands are examined. The approach is determined before surgery and may be modified during the operation according to the findings. Intra-operative nerve monitoring may be used to assist in identifying and protecting the recurrent laryngeal nerves, and frozen section analysis may be employed to confirm that the tissue removed is parathyroid tissue. The risk of a lasting voice change is low.

The principal challenge of parathyroid surgery is that the glands are small and their position can vary. In a small proportion of patients the abnormal gland cannot be identified at the initial operation, despite a thorough exploration. In this circumstance the operation may be concluded without cure, and further imaging or additional surgery may be considered at a later stage. Successful surgery is confirmed by biochemical testing after the operation, rather than by the appearance of the neck at the time of surgery.

After surgery for primary hyperparathyroidism, the remaining parathyroid glands may take some time to resume normal function, and a transient fall in calcium levels (hypocalcaemia) is occasionally seen. This may present with tingling around the mouth or in the fingers, or with muscle cramps. Calcium levels are monitored and the condition is readily treated with calcium and, if required, vitamin D supplementation. Most patients are discharged within one day of surgery, and the hypocalcaemia resolves as the remaining glands recover.

Patients with secondary hyperparathyroidism, most commonly related to chronic kidney disease, differ in that significant hypocalcaemia is expected in all cases after surgery. This is managed with intensive calcium and vitamin D replacement, and these patients may require a longer hospital stay for closer monitoring and adjustment of treatment. As with any neck operation, wound haematoma is uncommon but requires prompt attention, and the overall risk of wound complications is low. Individual risks depend on the underlying diagnosis and the extent of surgery, and are discussed in detail at the pre-operative consultation.

Parathyroidectomy is the removal of one or more of the parathyroid glands, which produce parathyroid hormone and regulate the level of calcium in the blood. Most patients are discharged within a day of surgery, and before you leave the nursing staff and I will explain how to care for yourself at home. For the first 24 hours after the anaesthetic you should not drive or operate machinery, make important decisions or sign legal documents, or drink alcohol. Pain is usually mild and is most noticeable when swallowing, so it is helpful to take your pain medication about 30 minutes before meals. Paracetamol is usually sufficient, and stronger medication will be prescribed if required. You may also be prescribed a calcium supplement, which should be taken exactly as instructed, as your calcium level may fall temporarily while the remaining parathyroid glands recover.

For the first few days a soft diet, such as soup, eggs, yoghurt, or puréed foods, will be more comfortable than hard or dry foods. Sleeping with the head and shoulders raised for about a week reduces swelling in the neck. A cold pack, wrapped in a thin towel and applied to the area for about 15 minutes every one to two hours, may relieve discomfort and swelling. The wound should be kept dry and covered for the first one to two days, after which it may be washed gently with soap and water in the shower and patted dry. It should not be submerged in a bath, pool, or the sea until it has healed completely. Please wash your hands before and after touching the wound or dressing, and do not pick at glue or tape, which will separate on its own. Activity should be increased gradually, starting with short walks around the home. Heavy lifting, strenuous exercise, and swimming should be avoided for at least one to two weeks, and I will advise you on this individually.

I will review you one to two weeks after the operation to assess your recovery, to discuss the pathology results, and to remove any non-absorbable sutures. A further review is usually with your referring endocrinologist arranged about six months later, with blood tests and any other investigations required, to confirm that the operation has been successful and that your calcium and parathyroid hormone levels remain normal. Attendance at these appointments is important.

Please contact my rooms for advice if you develop a temperature of 38°C or higher, or chills; redness, discharge, or increasing swelling at the wound; numbness or tingling around the lips or in the fingers, or muscle twitching or cramps, which may indicate a low calcium level, in which case you should take your calcium as instructed while you wait to speak to us; difficulty moving the lips or opening and closing the mouth; or nausea and vomiting persisting for more than two days after discharge. Rapidly increasing swelling of the neck, or any difficulty breathing, swallowing, or speaking, requires urgent attention, and you should go to the nearest emergency unit immediately and not wait for a return call.

Laparoscopic adrenalectomy is the removal of an adrenal gland through several small incisions, using a camera and fine instruments. Compared with open surgery, it is associated with less postoperative pain, smaller scars, and a faster recovery. Most patients require hospital care for one to two days after the operation, during which time pain control, mobilisation, blood pressure, and any hormonal requirements are monitored. Most patients are able to resume normal activities within a few weeks.

The principal risk of the laparoscopic approach is bleeding, as the adrenal glands have a rich blood supply and lie close to major vessels. The risk of conversion to an open operation is low. When conversion is necessary, it is usually to achieve safe control of bleeding, and it should be regarded as a decision made in the interest of patient safety rather than as a failure of the procedure. Other uncommon complications include injury to adjacent organs such as the spleen, pancreas, liver, kidney, or bowel, wound infection, and hernia at a port site. Temporary shoulder tip discomfort is common after laparoscopy and is related to the gas used to inflate the abdomen.

Because the adrenal glands produce hormones, the operation may also have physiological effects that depend on the underlying diagnosis. Patients whose tumours produce excess cortisol may have temporary or prolonged suppression of the remaining adrenal gland and may require steroid replacement for a period after surgery, with gradual withdrawal guided by hormonal testing. Patients with tumours that produce catecholamines (phaeochromocytoma) require careful pre-operative preparation and close monitoring of blood pressure during and after the operation. These issues are addressed in detail before surgery and are managed in conjunction with the endocrinology and anaesthetic teams.

As with any major abdominal operation, there is a small risk of deep vein thrombosis and of chest or urinary complications, which are minimised by early mobilisation and appropriate preventive measures. The overall risk of complications depends on the underlying diagnosis, the size and nature of the tumour, and the patient’s general health. These factors are discussed individually at the pre-operative consultation.

Laparoscopic adrenalectomy is the removal of an adrenal gland through several small incisions in the abdomen. Most patients are discharged one to two days after the operation, and before you leave the nursing staff and I will explain how to care for yourself at home. For the first 24 hours after the anaesthetic you should not drive or operate machinery, make important decisions or sign legal documents, or drink alcohol. Discomfort at the incision sites is usually mild to moderate, and you may also notice abdominal bloating or pain at the tip of the shoulder, which is caused by the gas used during laparoscopy and settles within a few days. Paracetamol, with or without an anti-inflammatory such as ibuprofen, is often sufficient, and stronger medication will be prescribed if required. If you are given an opioid-containing analgesic, constipation is common, and a stool softener may help. Your usual diet may be resumed as tolerated, beginning with light meals.

Depending on the reason for your operation, you may need medication after surgery that is specific to your condition. If your tumour produced excess cortisol, the remaining adrenal gland may take months to resume normal function, and you will be prescribed steroid replacement tablets. These must be taken exactly as instructed and should never be stopped or missed, and I will explain how the dose is reduced over time. If you have been taking blood pressure medication, your blood pressure may change after surgery, and your medication may need to be adjusted. Please monitor your blood pressure at home if you are able to, and report persistently low or high readings, or dizziness on standing.

The wounds should be kept dry and covered for the first one to two days, after which they may be washed gently with soap and water in the shower and patted dry. They should not be submerged in a bath, pool, or the sea until they have healed completely. Please wash your hands before and after touching the wounds or dressings, and do not pick at glue or tape, which will separate on its own. Activity should be increased gradually, starting with short walks around the home, which also reduce the risk of blood clots. Heavy lifting, strenuous exercise, and swimming should be avoided for at least two to four weeks, and I will advise you on this individually. I will review you one to two weeks after the operation to assess your recovery, to discuss the pathology results, and to arrange hormonal testing and endocrinology follow-up where this is required.

Please contact my rooms for advice if you develop a temperature of 38°C or higher, or chills; redness, discharge, or increasing swelling at the wounds; worsening abdominal pain or distension; or nausea and vomiting that persist for more than two days after discharge. If you are taking steroid replacement, please also contact us promptly if you are unable to keep your tablets down, or if you become unusually weak, dizzy, or faint, since this may indicate that your steroid dose is inadequate. Chest pain, sudden shortness of breath, or pain and swelling in one calf may indicate a blood clot, and you should go to the nearest emergency unit immediately and not wait for a return call.

Sarcomas are uncommon tumours arising from connective tissues, and they occur in many sites in the body, including the retroperitoneum, abdomen, and limbs. The nature of the operation therefore varies considerably according to the site, size, and type of tumour, and the plan for each patient is individualised after review of the imaging, the biopsy findings, and discussion at a multidisciplinary team meeting. The aim of surgery is complete removal of the tumour with a margin of normal tissue where this is achievable. In some patients, adjacent organs or structures need to be removed together with the tumour to achieve this. Treatment before or after surgery, such as radiotherapy or chemotherapy, may also be recommended depending on the tumour type.

Surgery for sarcoma is usually major surgery performed through an abdominal incision (laparotomy). The expected hospital stay is typically between five and ten days, although this may be shorter or longer depending on the extent of the operation and the patient’s recovery. Some patients are monitored in a high care or intensive care unit in the immediate postoperative period, particularly after extensive resections or where there are significant co-morbidities. Recovery after discharge continues over several weeks, and the return to full activity is gradual.

As with any major abdominal operation, there are risks of bleeding, wound infection, delayed return of bowel function, and complications affecting the chest, heart, or urinary tract. Blood clots in the legs or lungs are a recognised risk and are reduced by preventive medication and early mobilisation. Where parts of the bowel or other organs are removed, there is a risk of leakage from a join (anastomosis) or of fluid collections, which may require additional treatment. Injury to adjacent structures, including major blood vessels, the ureter, or nerves, is uncommon but is a recognised risk when tumours are closely related to these structures. Wound healing problems and incisional hernia may occur later.

The specific risks depend on the location and extent of the tumour, the organs involved, and the patient’s general health, and these are discussed in detail at the pre-operative consultation. It is also important to appreciate that sarcomas may recur after surgery, even when removal appears complete. For this reason, long-term follow-up with regular clinical review and imaging forms part of the overall treatment plan.

Recovery after sarcoma surgery is individualised according to the extent of the operation and the structures involved. Most patients will have been in hospital for several days to a week or more, and discharge is planned once pain is controlled, mobility is adequate, and bowel function has returned. For the first 24 hours after discharge with an anaesthetic still in your system you should not drive or operate machinery, make important decisions or sign legal documents, or drink alcohol.

Pain management at home should follow the discharge instructions. Paracetamol and an anti-inflammatory are often used together, and if you have been prescribed an opioid-containing analgesic, constipation is common and a stool softener may help. Activity should be increased gradually, starting with short walks, which also reduce the risk of blood clots. Heavy lifting, strenuous exercise, and swimming should be avoided until you are advised that these are safe, which is typically four to six weeks after major abdominal surgery, but may be longer depending on the operation.

The wound should be kept dry and covered for the first few days, after which it may be washed gently with soap and water in the shower and patted dry. It should not be submerged in a bath, pool, or the sea until it has healed completely. Please wash your hands before and after touching the wound or dressing. I will review you after the operation to assess your recovery and to discuss the pathology results. Depending on the tumour type and the treatment plan, I may also arrange follow-up with an oncologist, and long-term surveillance with regular imaging will be scheduled.

Please contact my rooms for advice if you develop a temperature of 38°C or higher, or chills; redness, discharge, or increasing swelling at the wound; worsening abdominal pain or distension; nausea and vomiting persisting for more than two days after discharge; or pain, redness, or swelling in one calf, or sudden shortness of breath, which may indicate a blood clot. Any of these symptoms requires prompt attention, and in the case of chest pain, sudden shortness of breath, or severe abdominal pain, you should go to the nearest emergency unit immediately and not wait for a return call.

Splenectomy is the removal of the spleen, an organ in the upper left part of the abdomen that helps the body fight infection and filters the blood, removing damaged blood cells and bacteria. It is most often recommended for blood disorders such as immune thrombocytopenia (ITP), autoimmune haemolytic anaemia or beta thalassaemia major, for an enlarged spleen that is causing symptoms, or after an injury. Wherever possible the operation is done laparoscopically, through two to four small incisions in the abdomen. A very large spleen usually needs open surgery.

Because the main long-term risk of living without a spleen is infection, you will need vaccines against pneumococcus, Haemophilus influenzae type b (Hib) and meningococcus, ideally at least two weeks before surgery. If the spleen needs to be removed urgently, the vaccines are given afterwards instead. Each case is planned with your haematologist or physician, including any need for platelets or a transfusion around the time of surgery.

The operation is done under general anaesthetic and usually takes two to three hours. During the operation a careful search is made for accessory spleens, small extra pieces of spleen tissue that could allow a blood disorder to return if they were left behind.

The possible risks include bleeding, infection and blood clots, and you will be given medication to help prevent clots while you are in hospital. You can live well without a spleen, but your body will find some infections harder to fight, so even a minor infection needs prompt attention, and your risk of blood clots is also higher.

After laparoscopic surgery you may be able to go home sooner than after open surgery, which usually needs a stay of a few days. For the first 24 hours after surgery, do not drive or operate machinery, drink alcohol, or make important decisions or sign important documents.

Take your medicines as instructed. Paracetamol or an anti-inflammatory such as ibuprofen can be used for pain, and a stool softener helps prevent constipation if you need stronger painkillers. You will usually be given antibiotics to keep at home so that you can start treatment straight away if you develop an infection; make sure you know how and when to take them. If you did not have all your vaccines before surgery, you will have them afterwards.

Keep the wounds dry and covered for the first one to two days, after which they may be washed gently with soap and water in the shower and patted dry. Avoid baths and swimming until they have healed. Increase your activity gradually, starting with short walks, and keep up deep breathing and coughing exercises for seven to ten days, supporting the wound with a pillow. Avoid heavy lifting and sport for at least one to two weeks. Pain in the shoulder tip is common after laparoscopic surgery; it comes from the gas used during the operation and eases as you move about.

You will be seen in my rooms after the operation to check on your progress. Stitches or staples, if used, are usually removed after one to two weeks.

Call 112 or go to your nearest emergency centre if you become short of breath, have sharp chest pain when breathing, have severe abdominal pain, or feel faint. Please contact my rooms for advice if you develop a temperature of 38°C or higher, or chills; swelling, pain, warmth or redness in your leg; redness or swelling around the wounds; or nausea or vomiting for more than two days after going home.