Minimally Invasive Parathyroidectomy

This technique involves trying to locate the abnormal gland prior to surgery and using a well concealed, tiny incision to remove it.

Usually we can remove the gland in under 15 minutes with minimal disruption of the neck tissues. Once removed, we check your blood hormone levels while you're still asleep. If it doesn't return to normal then the remaining glands are found and examined. Depending on the patient we may perform a 4-gland exploration before drawing blood levels. Making "all or none" statements when it comes to the complexity of surgery and the human body just is not possible.

Still, you can be discharged them the same day and avoid the need for drains, staples or sutures to be removed. All incisions are closed in a cosmetic fashion using plastic surgery closure techniques including dissolvable suture on the inside and skin glue on the surface. All of this equates to a rapid recovery.

The preoperative workup includes an ultrasound performed in the office and possibly a sestamibi scan, SPECT-CT or 4D CT scan. The ultrasound can help locate the large gland while the sestamibi can help find the hyperfunctional gland. Most importantly, it helps us ensure there isn't a gland where is aught not be.  Usually the results of these scans will overlap providing us with an excellent starting point. Many times the imaging will be completely non-localizing. Not to worry! This is very common and does not mean that surgery isn't needed. The decision to operate is made based on your personal history and labs. Imaging is nice but not diagnostic. We'll also request an additional set of laboratory tests and take a look at the nerve function to your voice box using a small, painless camera through the nose.

It's critical that you have the correct surgery on the first attempt by a experienced parathyroid surgeon. Re-operative surgery can be challenging and there are less complications with a specialized surgeon. Patients can feel confident if they have surgery with a high-volume surgeon who understands the nuances of endocrine surgery.