Parathyroidectomy

A parathyroidectomy is a surgical procedure that involves the removal of one or more parathyroid glands located behind the thyroid in the neck. This intervention is commonly performed to address hyperparathyroidism, a condition marked by excessive secretion of parathyroid hormone (PTH), leading to elevated blood calcium levels.

The surgical removal of affected glands aims to restore normal calcium balance in the body, alleviating symptoms such as kidney stones and bone loss associated with hyperparathyroidism.

Overview

Why are Parathyroidectomies performed?

Because hyperparathyroidism is often a result of a benign tumor of the parathyroid glands, parathyroid surgery is often necessary to address the condition. Unlike an overactive thyroid that can usually be treated with medication and other conservative treatments, the parathyroid glands will generally not return to normal function until tumors have been removed.

Fortunately, modern surgical techniques have facilitated procedures that leave minimal scarring, with reduced damage to healthy tissues for more successful surgical outcomes. Our parathyroid surgeon, Dr. Jason Cohen, and his team specialize in minimally invasive parathyroid surgery. Unlike traditional parathyroid surgery, you don’t need to worry about an unsightly scar on your neck.

What is a Minimally Invasive Parathyroidectomy (MIP)?

In recent years, Minimally Invasive Parathyroidectomy (MIP) has emerged as the preferred method for excising tumors from the parathyroid glands. This surgical approach boasts a high success rate and significantly fewer complications compared to traditional parathyroid surgery.

About 85% of patients with hyperparathyroid disease have a parathyroid adenoma in only one of the four glands. Unlike the conventional method that requires opening the neck to expose all four glands, MIP utilizes a remarkably small incision (about an inch) to extract the tumor. After removing the abnormal gland, Dr. Cohen measures the parathyroid hormone level to ensure that it returns to the normal range. If the level does not come down appropriately then Dr. Cohen will visualize the other glands.

The advantages of this minimally invasive technique include a lower risk of complications, a shorter recovery period, and a nearly imperceptible scar.

Preparing for a Parathyroidectomy

During the Parathyroidectomy

The prospect of undergoing anesthesia and parathyroid surgery may evoke various concerns and anxieties. However, rest assured that you are in capable hands throughout the entire procedure. Our dedicated team is committed to the successful completion of the operation and ensuring your comfort post-surgery.

Given the small size of the parathyroid glands, the surgery may extend up to four hours. While under general anesthesia, your surgeon will meticulously locate and remove the impacted gland and tumors, prioritizing the preservation of surrounding nerves and blood vessels. During the surgery we specifically monitor the vocal chord nerve to prevent any damage to the voice. Despite the intricacy of the surgery, the incidence of complications is remarkably low.

After the Parathyroidectomy

Following the surgery, you may spend one night in the hospital or be discharged to go home after 6 hours. As the effects of anesthesia persist for several hours afterward, arranging transportation is advisable, as you won’t be able to drive yourself. Post-surgery, it is common to experience soreness and mild pain in the back of the neck, along with symptoms such as:

  • Swelling and/or bruises
  • Slight sore throat and scratchy voice for 2-3 days
  • Minimal pain in the incision area

These symptoms are entirely normal and may persist for several weeks after the procedure. During the initial week after surgery, Dr. Cohen recommends patients¬† to take it easy, avoiding strenuous activities (like working out), icing the incision for the first 2-3 days but resuming regular normal activity. There is a follow-up visit one week after surgery and final follow-up 6 months post surgery which can be done virtually if the patient is from out of town.¬† It’s crucial to seek clearance from your parathyroid surgeon before resuming exercise or engaging in other physical activities.

Benefits

What are the Advantages of Minimally Invasive Parathyroidectomy?

Limited to No Hospital Stay:
The prospect of being away from home can be unsettling for many. However, with this surgery requiring general anesthesia, patients typically either spend one night in the hospital or have the ability to return home after the procedure is completed. This eliminates the need for an extended hospital stay, allowing for recovery in the comfort of your familiar environment.

Quick Recovery Time:
Minimally invasive parathyroid surgery, characterized by its minimal scarring, significantly shortens the recovery time. The absence of a large scar contributes to lower postoperative pain levels. In just a few weeks post-surgery, patients can expect to resume their regular routines.

Minimal Scarring:
In contrast to traditional parathyroid surgery, which often results in a prominent neck scar, minimally invasive parathyroid surgery leaves a small and nearly invisible scar. Measuring at just about an inch, the inconspicuous scar addresses potential cosmetic concerns, ensuring that the surgery leaves little to no visible impact and minimizes any feelings of insecurity.

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