What is Parathyroid Surgery?
Parathyroid surgery, also called parathyroidectomy, is the surgical removal of one or more parathyroid glands.
The parathyroid glands are four small glands present in your neck behind the thyroid gland. They secrete parathyroid hormone (PTH) which regulates the calcium levels in your body.
What are the Indications of Parathyroid Surgery?
Parathyroid surgery is recommended for the treatment of:
- Hyperparathyroidism, a condition where one or more parathyroid glands become enlarged and secrete excess amounts of parathyroid hormone
- Tumors of the parathyroid gland
Preparation of Parathyroid Surgery
You are required to undergo a complete medical check-up before your parathyroid surgery which includes blood tests and a head and neck scan. In case you are on blood-thinning medications such as aspirin, you may be asked to stop them prior to your surgery.
Surgical procedure
You are placed in the supine position on your back and administered general anesthesia.
There are different ways to perform parathyroid surgery. These include:
- Traditional method: In this technique, a single long incision is made along the crease in your neck. Your surgeon moves aside the neck muscles and the thyroid gland to locate the parathyroid glands. The diseased gland or the tumor is removed, and the incision is closed.
Newer techniques for parathyroid surgery include the following:
- Radio-assisted parathyroidectomy: In this technique, you are administered a radioactive substance that can be absorbed by the parathyroid glands. Then a probe is used to locate the glands and based upon the location, the incision is then made over the site. The gland or tumor is removed, and the incisions are sutured closed.
- Endoscopic parathyroidectomy also called video-assisted parathyroidectomy: In this technique, a few small incisions are made in your neck along the crease to minimize scarring. Then, an endoscope with an attached camera is inserted through one of the incisions, and tiny surgical instruments are inserted through the other incision. The gland or tumor is then removed. After this, the endoscope and the other instruments are removed. The incisions are closed using surgical glue or stitches.
Postoperative care
- If you have undergone a minimally invasive parathyroid surgery, you may be discharged from the hospital the same day. However, if you have undergone the traditional open parathyroid surgery, you may be required to stay longer.
- Your blood calcium levels will be monitored following your surgery. If they fall low, you may experience symptoms of hypocalcemia such as muscle cramping, tingling, or numbness. These can be relieved by taking calcium supplements and if needed, vitamin D.
- Your doctor may also prescribe medications for pain relief to keep you comfortable.
- You should avoid exposure of the neck incision to direct sunlight and getting it wet.
- If you experience continuous tingling despite taking medications, you should contact your doctor for follow-up.
- Activities such as walking and mild exercises are encouraged following surgery. Avoid lifting heavyweight and intense exercises for a few weeks.
- You can resume work and driving when you feel comfortable.
- You will be instructed to drink plenty of fluids and resume a balanced diet as tolerated.
Risks and Complications of Parathyroid surgery
As with any surgery, risks and complications can occur. Parathyroid surgery may have the following risks:
- Side-effects of anesthesia
- Nerve injury
- Breathing difficulty
- Bleeding
- Blood clots
- Infection
- Low calcium levels
Summary
Parathyroid surgery is recommended for the treatment of hyperparathyroidism and parathyroid gland tumors. It can be performed as a minimally invasive surgery through small incisions which offers benefits such as reduced postoperative pain, minimal scarring, a brief hospital stay, and a quicker recovery.
