(Parathyroid Gland Removal—Minimally Invasive; Video-assisted Parathyroidectomy; Endoscopic Parathyroidectomy; Radio-guided Parathyroidectomy; Parathyroidectomy, Video-assisted; Parathyroidectomy, Endoscopic; Parathyroidectomy, Radio-guided)
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A parathyroidectomy is a surgery to remove parathyroid glands. There are four parathyroid glands located in the neck. The glands make a hormone that balance the level of calcium in the blood.
Reasons for Procedure
The surgery is done to remove one or more abnormal parathyroid glands. The glands can be abnormal due to cancer or for other reasons.
A minimally invasive approach is usually done if only one gland needs to be removed. If more than one gland needs to be removed or if the doctor needs to do additional surgery in the neck, a conventional approach may used instead, which involves making larger incisions.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Low calcium levels in the blood (more common if all four glands are removed)
- Wound infection
- Reaction to the anesthesia
- Skin tethering—tissues and skin may become attached to the voice box or windpipe
- Blocked airway
- Damage to nerves (which can cause problems like paralyzed vocal cords)
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
What to Expect
Prior to Procedure
Your doctor will:
- Do a physical exam and ask you about your medical history
- Order imaging test such as ultrasound or parathyroid scan
- Have blood tests done
- Arrange to have someone drive you home from the hospital after surgery.
- Avoid eating or drinking 6-8 hours before surgery.
- Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure.
General anesthesia is used most often. It will block any pain and you will stay asleep through the surgery. In some cases, local anesthesia may be used instead. The area will be numb but you will be awake.
Description of the Procedure
There are different types of minimally invasive surgeries that may be used, such as:
Video-assisted Parathyroidectomy (Endoscopic Parathyroidectomy)
A small incision will be made in the neck. A small tube with a tiny camera will be passed through the incision. The images from the camera will be sent to a TV monitors so the doctor can see the glands. Other small tools will be passed through the tube to detach and remove the gland. Once the gland has been removed, the incision will be closed with stitches.
A radioactive substance will be injected into your body. The abnormal gland will absorb the substance but the healthy glands will not. A small incision will be made in the neck and a small probe will be inserted. The probe will detect signals that are given off by the radioactive substance in the abnormal gland. This will help the doctor find the abnormal gland. Other small tools will be passed through the tube to detach and remove the gland. Once the gland has been removed, the incision will be closed with stitches.
With either surgery, if all four glands were removed, a part of one gland may be placed in a different area of the neck or in the forearm.