Parathyroid surgery is typically performed to remove a parathyroid adenoma. Some patients may require surgery for multiple adenomas, parathyroid hyperplasia, and in rare cases parathyroid carcinoma. After the diagnosis is made, imaging studies including (sestamibi scan, ultrasound, and/or CT scan) can be helpful to localize the problematic gland.
We can use several different surgical approaches to perform these procedures.
The traditional "open" parathyroid exploration method uses a 4-6 cm horizontal incision in the lower neck to expose the thyroid, parathyroids, and surrounding structures. Fortunately with current imaging technology, this procedure rarely needs to be performed.
A "minimally invasive" approach, with or without an endoscope, can be performed in most cases to reduce the incision size to between 2-4 cm.
In selected patients, we can completely eliminate neck incisions using the da Vinci Surgical System to perform robot-assisted endoscopic parathyroid surgery.
The potential risks of parathyroid surgery include:
- Bleeding which may compress the airway.
- Injury to the superior or recurrent laryngeal nerves which may cause hoarseness or airway obstruction. This may be temporary or permanent.
- Temporary or permanent hypocalcemia (low calcium levels), requiring calcium and vitamin D supplementation.
- Persistent hypercalcemia (elevated calcium levels), requiring further surgery