(Parathyroid Gland Removal—Minimally Invasive; Video-assisted Parathyroidectomy; Endoscopic Parathyroidectomy; Radio-guided Parathyroidectomy; Parathyroidectomy, Video-assisted; Parathyroidectomy, Endoscopic; Parathyroidectomy, Radio-guided)
A parathyroidectomy is a surgery to remove parathyroid glands. There are four parathyroid glands located in the neck. The glands make a hormone that balance the level of calcium in the blood.
Reasons for Procedure
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 not common 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:
Factors that may increase the risk of complications include:
Talk to your doctor about these risks before the surgery.
What to Expect
Prior to Procedure
Your doctor will:
General anesthesia is used most often. It will block any pain and you will stay asleep through the surgery.
In some cases, local anesthesia may be used instead. The area will be numb but you will be awake.
Description of the Procedure
There are different types of minimally invasive surgeries that may be used, such as:
Video-assisted Parathyroidectomy (Endoscopic Parathyroidectomy)
A small incision will be made in the neck. A small tube with a tiny camera will be passed through the incision. The images from the camera will be sent to a TV monitors so the doctor can see the glands. Other small tools will be passed through the tube to detach and remove the gland. Once the gland has been removed, the incision will be closed with stitches.
A radioactive substance will be injected into your body. The abnormal gland will absorb the substance but the healthy glands will not. A small incision will be made in the neck and a small probe will be inserted. The probe will detect signals that are given off by the radioactive substance in the abnormal gland. This will help the doctor find the abnormal gland. Other small tools will be passed through the tube to detach and remove the gland. Once the gland has been removed, the incision will be closed with stitches.
With either surgery, if all four glands were removed, a part of one gland may be placed in a different area of the neck or in the forearm.
How Long Will It Take?
Between 30 minutes and 1-2 hours (depending on the type of surgery)
How Much Will It Hurt?
Average Hospital Stay
You may need to stay in the hospital for a day or you may be able to leave the same day. Ask your doctor if this is an option for you. Your doctor may also choose to keep you longer if you have any problems.
At the Hospital
The hospital staff will:
Be sure to follow your doctor’s instructions. To help your recovery at home:
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
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 Cancer Society
Canadian Society of Otolaryngology
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Parathyroid surgery. The American Association of Endocrine Surgeons website. Available at: http://www.endocri... . Accessed June 18, 2013.
Parathyroidectomy. Cedars-Sinai website. Available at: http://acromegalys... . Accessed June 18, 2013.
Parathyroidectomy: minimally invasive (focused). University of California, Los Angeles Endocrine Surgery website. Available at: http://endocrinesurgery.ucla.edu/surgery_mip.html . Accessed June 18, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed June 2013 by Kim Carmichael, MD