Minimally Invasive Parathyroid Surgery

WHAT YOU SHOULD KNOW:

Minimally invasive parathyroid surgery is surgery to remove all or part of a parathyroid gland. The parathyroid is made of 4 small glands that usually sit near the thyroid gland. The parathyroid glands make a hormone that controls the amount of calcium in your blood.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • During or after surgery, you may bleed more than expected, or get an infection. Your thyroid gland, blood vessels, or other tissues may be damaged during surgery. You may have nerve or vocal cord damage. You may have a hoarse or weak voice that lasts for a few days or longer. Your blood calcium level may be lower than normal after surgery. You may get a blood clot in your leg or arm. This can cause pain and swelling, and can become life-threatening.

  • If you do not have surgery, an overactive parathyroid gland could cause elevated blood calcium levels. This could cause fatigue, and bone, joint, or muscle pain. You may also have headaches, muscle spasms, weak bones, a broken bone, hallucinations, and confusion. Cancer of your parathyroid gland that is left untreated may prevent your kidneys from working correctly. You may also develop kidney stones or congestive heart failure. These conditions can become life-threatening.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Anesthesia is medicine to make you comfortable during the surgery. Caregivers will work with you to decide which anesthesia is best for you.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Local anesthesia is a shot of medicine put into your neck. It is used to numb the area and dull the pain. You may still feel pressure or pushing during surgery.

  • Tests:

    • Blood tests may be done to check your parathyroid hormone level.

    • A scan may be done right before your surgery to help caregivers know which parathyroid glands are overactive. Radioactive dye is put into your IV to help caregivers see your parathyroid glands and know which gland needs to be removed. Caregivers will use a camera above your neck and chest to look for the parathyroid glands that absorbed the dye.

    • An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show the size and location of each parathyroid gland in your neck.

During your surgery:

  • A small incision will be made in one side of your neck. Your surgeon will gently lift and move muscles and other structures to see the parathyroid gland. A handheld probe (wand) and camera may be used during the surgery to find the parathyroid gland that needs to be removed. Part or all of the parathyroid gland will then be removed.

  • Your surgeon may also insert a small scope through small incisions on your neck, or chest and underarm. He may insert other instruments in 1 to 2 smaller incisions at different places on your neck or armpit. He will then inject a gas (carbon dioxide) in the neck area near your parathyroid gland. This will lift the skin of your neck away from the parathyroid and allow your surgeon more space to work in. Clips, cautery, loops, or staples may be used to separate the gland from other structures near it. Blood tests may be done during surgery to check your parathyroid hormone level. The incisions will be closed with stitches or surgical tape and covered with bandages.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. A caregiver will check your incision soon after your surgery to make sure everything is okay. When your caregiver sees that you are okay, you will be able to go home or be taken to your hospital room.

  • Blood tests may be done to check your parathyroid hormone level to see if you need more surgery.

  • You may need to walk around the same day of surgery , or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Medicines:

    • Antibiotics are given to help treat or prevent a bacterial infection.

    • Pain medicine may be given to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

    • Antinausea medicine may calm your stomach and help prevent vomiting.

    • Calcium may be given as a pill or through your IV. It will help keep your blood calcium at a normal level. It may also help treat or prevent bone loss.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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