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.

Getting Ready

The week before your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • You may need blood tests, an electrocardiogram (EKG), chest x-ray, or other tests before your surgery. Talk to your caregiver about these and other tests you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • You may be given medicine to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • Your caregiver may give you an IV injection of a radioactive dye 1 to 2 hours before your surgery. This will help him clearly see your parathyroid glands during surgery.

Treatment

What will happen:

  • 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 glands. 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.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever.

  • You get a cold or the flu.

  • You have a skin or wound infection near the area where surgery will be done.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You have new symptoms since the last time you saw your caregiver, or your symptoms are getting worse.

  • You feel too depressed or sad, or think that you cannot cope with life or your problems.

© 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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