What is a parathyroidectomy?
Parathyroidectomy is a surgical procedure to remove one or more overactive parathyroid glands or tumors affecting them. The parathyroid glands, each about the size of a grain of rice, are crucial for maintaining calcium balance in the body. When these glands become overactive, it can lead to conditions like hyperparathyroidism, causing symptoms such as weak bones, kidney stones, and fatigue.
Why is a parathyroidectomy done?
Patients needing a Parathyroidectomy when the parathyroid glad produces too much parathyroid hormone known as hyperparathyroidism. Primary hyperparathyroidism, often caused by adenomas or gland enlargement, typically requires surgery to alleviate symptoms and restore calcium levels.
Secondary hyperparathyroidism, stemming from conditions like kidney disease, may also necessitate surgery if symptoms persist despite other treatments.
What are the risks of parathyroidectomy?
While parathyroidectomy is generally safe, potential risks include infection, hematoma, and long-term calcium level issues. Before the procedure, imaging tests like sestamibi scans and ultrasounds help locate problematic glands. The surgery, usually performed under general anesthesia, involves various approaches, including minimally invasive and bilateral neck exploration, tailored to individual cases.
What does the parathyroidectomy procedure entail?
There are several surgical options that can be used for parathyroidectomy. The primary procedures The Iowa Clinic General Surgery department uses for parathyroidectomy are minimally invasive and bilateral neck exploration.
Minimally Invasive Surgery
This approach is commonly used when only one of the parathyroid glands is overactive. Prior to surgery, imaging tests such as sestamibi scans and ultrasounds are utilized to precisely locate the overactive gland.
The surgeon makes a small incision, typically less than an inch, in the neck area. Using the information from pre-operative imaging, the surgeon precisely identifies and removes the overactive gland while minimizing damage to surrounding tissues.
Minimally invasive surgery offers several benefits, including shorter recovery times, less post-operative pain, and reduced scarring.
Bilateral Neck Exploration
In certain cases where minimally invasive surgery isn't feasible or when multiple glands are suspected to be overactive, bilateral neck exploration (also known as parathyroid exploration) may be performed. This approach involves a larger incision in the neck, allowing the surgeon to visually inspect all four parathyroid glands.
The surgeon carefully examines each gland to identify those that are overactive or affected by tumors. If more than one gland is found to be overactive, all affected glands are removed during the procedure.
Bilateral neck exploration may be preferred in cases where imaging tests are inconclusive or when there is a higher likelihood of multiple glands being involved.
While this approach may result in a longer recovery period and slightly more discomfort compared to minimally invasive surgery, it remains an effective option for addressing hyperparathyroidism when indicated.
Both minimally invasive surgery and bilateral neck exploration are tailored to the individual patient's needs and the specifics of their condition, with the ultimate goal of alleviating symptoms and restoring calcium balance in the body.