Parathyroidectomy—Minimally Invasive
En Español (Spanish Version)
A parathyroidectomy is a surgery to remove abnormal parathyroid glands. There are four parathyroid glands located in the neck. The glands make parathyroid hormone, which is used to control
calcium
levels in the blood.
Parathyroid Glands and Thyroid Glands (Back View)
Copyright © Nucleus Medical Media, Inc.
The surgery is done to remove one or more abnormal parathyroid glands. The glands can be abnormal due to cancer or for other reasons.
A minimally invasive approach is usually done if only one gland needs to be removed. If more than one gland needs to be removed or if the doctor needs to do additional surgery in the neck, she may use a conventional approach instead, which involves making larger incisions.
Complications are rare. But, no procedure is completely free of risk. If you are planning to have a parathyroidectomy, your doctor will review a list of possible complications, which may include:
- Bleeding
- Hoarseness
- Low calcium levels in the blood
- Wound infection
- Reaction to the anesthesia
- Skin tethering—tissues and skin may become attached to the voice box or windpipe
- Scarring
- Blocked airway
- Damage to nerves (which can cause problems like paralyzed vocal cords)
Factors that may increase the risk of complications include:
Talk to your doctor about these risks before the surgery.
Your doctor will:
- Do a physical exam and ask you about your medical history
- Order imaging scans (eg, ultrasound)
- Have blood tests done
You should:
- Arrange to have someone drive you home from the hospital after surgery.
- Avoid eating or drinking 6-8 hours before surgery.
-
Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin
and other nonsteroidal anti-inflammatory drugs (eg,
ibuprofen
,
naproxen
)
-
Blood-thinning drugs, such as
warfarin
(Coumadin)
-
Anti-platelet drugs, such as
clopidogrel
(Plavix)
General anesthesia
will be used. It will block any pain. You will stay asleep through the surgery. In some cases, local anesthesia may also be used.
There are different types of minimally invasive surgeries that may be used, such as:
The doctor will make a 1¼ inch (3 centimeter) cut in the neck. She will then insert a scope with a tiny camera attached. This camera will send images to the TV monitors. The doctor will rely on these images to find the abnormal gland.
The doctor will inject a radioactive substance into your body. The abnormal gland, and not the healthy ones, will absorb the substance. The doctor will then make a 1 inch (2½ centimeter) cut in the neck. She then will insert a small probe. The probe will detect signals that are given off by the radioactive substance. This will help the doctor find the abnormal gland.
Once the gland has been removed, the doctor will close the area with stitches.
Between 30 minutes and 1-2 hours (depending on the type of surgery)
Anesthesia prevents pain during surgery. After the surgery, you may feel like you have a
cold
or
sore throat
. Your doctor will give you pain medicine.
This procedure is most commonly done in a hospital setting. If so, the usual length of stay is one day. It may be possible to leave the hospital on the same day of the procedure. Ask your doctor if this is an option for you. But, if you have any problems, you will need to stay longer.
The hospital staff will:
- Observe you in the recovery room
- Check on your ability to swallow and speak
- Show you how to change your dressings and care for your wound
When you return home, do the following to help ensure a smooth recovery:
- You may be given calcium supplements.
- Check your wound daily for signs of infection.
- You may want to eat semi-solid foods, like ice cream or oatmeal, for the first few days. These types of foods will be easier to swallow.
- Be sure to follow your doctor’s instructions.
After you leave the hospital, contact your doctor if any of the following occurs:
- Tingling or numbness in the fingertips, toes, hands, or around the mouth
- Twitching or cramping of muscles
- Redness, warmth, drainage, or swelling around the area where surgery was done
- Difficulty swallowing, talking, or breathing
- Signs of infection, including fever and chills
In case of an emergency, call for medical help right away.
The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS)
The American Association of Endocrine Surgeons
National Cancer Institute
Canadian Society of Otolaryngology
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Last Reviewed June 2012