Surgery for Parathyroid Tumors

Minimally Invasive Approach

At Scott & White, the majority of our parathyroidectomies are performed with minimally invasive techniques. Benefits of minimally invasive parathyroidectomy and radio-guided parathyroidectomy include:

  • Better cosmetic result
  • Quicker recovery times, allowing you to:
    • Return to your daily routine sooner
    • Begin future treatment sooner
  • Shorter hospital stay
  • Less pain
  • Less blood loss
  • Lower risk of infection
  • Fewer complications

Not all patients are candidates for a minimally invasive approach. Factors affecting the decision to use minimally invasive techniques include:

  • Tumor size, stage or location
  • Patient obesity and health
  • Prior surgeries

Noncancerous (Benign) Parathyroid Tumors

About 99 percent of tumors on your parathyroid gland are noncancerous (benign); cancerous parathyroid tumors are extremely rare.

At Scott & White, noncancerous parathyroid tumors are routinely treated with a minimally invasive parathyroidectomy or a radio-guided parathyroidectomy. Both procedures are described in the sections below.

During the operation, the surgery team also employ two special patient-monitoring techniques:

  • Intraoperative quick parathyroid hormone (qPTH) monitoring helps your surgeon confirm that the overactive parathyroid gland has been successfully identified and removed.
  • Intraoperative nerve monitoring to help locate and protect the nerves surrounding your tumor, particularly the nerves of your voice box (larynx).

As with all operations, there are some risks. Your surgeon will discuss these risks with you.

Surgical Procedures

Parathyroidectomy

In this procedure, your surgeon will make a small incision on the front of your neck to remove the affected parathyroid gland.

For many patients, routine parathyroidectomy is performed under local anesthesia or with a short general anesthetic as an outpatient procedure.

Minimally Invasive Radio-Guided Parathyroidectomy (MIRP)

In this procedure, your surgeon will use a small gamma probe that detects radioactivity in the affected parathyroid gland after an injection of a radioisotope the morning of surgery. This allows your surgeon to precisely identify and remove the abnormal parathyroid gland quickly and easily.

Advantages of the MIRP procedure include:

  • Surgical procedures take place on only one side of your neck, rather than both
  • You will need only localized anesthesia, rather than general anesthesia

In some cases, your MIRP procedure may be performed on an outpatient basis.

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Cancerous (Malignant) Parathyroid Tumors

Surgery to completely remove the parathyroid cancer is usually the first and most effective treatment. In most cases, your endocrine surgeon will remove the parathyroid tumor and surrounding tissues, including the thyroid lobe and adjacent lymph nodes.

“This more involved surgery is necessary only in the very rare patients with parathyroid cancer. Most patients with hyperparathyroidism have noncancerous (benign) adenomas that are making too much parathyroid hormone and causing high levels of calcium in the bloodstream, or hypercalcemia. Almost all patients with hyperparathyroidism due to adenomas can undergo a minimally invasive operation to successfully cure this condition,” says Terry C. Lairmore, MD, Endocrine Surgeon and Chief of Surgical Oncology.

As with all operations, there are some risks. Your surgeon will discuss these risks with you.

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