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Parathyroidectomy	Parathyroidectomy - series

Parathyroid gland removal

Definition

Parathyroidectomy is surgery to remove parathyroid glands or parathyroid tumors. The parathyroid glands are right behind your thyroid gland in your neck. These glands help your body use calcium.

Alternative Names

Removal of parathyroid gland; Parathyroidectomy

Description

You will probably receive general anesthesia (asleep and pain-free) for this surgery. Or you may receive local anesthesia and medicine to relax you. You will be awake but pain-free.

Usually the parathyroid glands are removed in open surgery, through a large incision (cut).

• Your surgeon will make a 4 - 6 inch incision in your neck just under your Adam's apple.
• Your surgeon will find the 4 parathyroid glands and remove any that are diseased.
• You may have a special blood test during surgery that will tell if all the diseased glands were removed.

Your surgeon may use 1 of these 3 other surgery techniques. Your surgeon must know where any diseased parathyroid glands are before using any of these techniques.

• Minimally invasive parathyroidectomy: You may receive a shot of nuclear material before this surgery. If you have this shot, your surgeon will use a special probe, similar to a Geiger counter, to locate the parathyroid gland. Your surgeon will make a small cut (1 to 2 inches) on one side of your neck, and then remove the diseased gland through it. This procedure takes about 1 hour.
• Video-assisted parathyroidectomy: Your surgeon will make two small cut in your neck. One is for instruments, and the other is for a camera. Your surgeon will use the camera to see the area and will remove the diseased glands with the instruments.
• Endoscopic parathyroidectomy: Your surgeon will make two or three small incisions in the front of your neck and one cut above the top of your breastbone. A newer technique makes this third cut under your arm. This reduces visible scarring, pain, and recovery time. This cut is less than 2 inches long. The procedure to remove any diseased parathyroid glands is similar to video-assisted parathyroidectomy.

Risks

Risks for any anesthesia are:

• Reactions to medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Infection

Risks for parathyroidectomy are:

• Injury to the thyroid gland or the need to remove part of the thyroid gland
• Hypoparathyroidism. This can lead to low calcium levels that are dangerous to your health.
• Injury to the nerves in your vocal cord. You may have a weaker voice or a hard time swallowing thin liquids.
• Difficulty breathing. This is very rare and almost always goes away several weeks or months after surgery.

Review Date: 1/30/2009
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.