A parathyroidectomy is a surgery to remove parathyroid glands. There are 4 parathyroid glands located in the neck. The glands make a hormone that balance the level of calcium in the blood.
Parathyroid and Thyroid Glands (Back View)
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The surgery is done to remove abnormal parathyroid glands. The glands can be overactive, or abnormal due to cancer or for other reasons.
A minimally invasive approach is usually done if only 1 gland needs to be removed. If more than 1 gland needs to be removed or if the doctor needs to do additional surgery in the neck, a conventional approach may be used instead, which involves making larger incisions.
Problems from the procedure are rare, but all procedures have some risk. Complications may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
Your doctor will:
General anesthesia is used most often. It will block any pain and you will stay asleep through the surgery. In some cases, local anesthesia and sedation may be used instead. The area will be numb but you will be awake.
There are different types of minimally invasive surgeries that may be used, such as:
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 or surgical glue.
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 or surgical glue.
Between 30 minutes and 1-2 hours (depending on the type of surgery)
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
You may need to stay in the hospital for a day or you may be able to leave the same day. Ask your doctor if this is an option for you. Your doctor may also choose to keep you longer if you have any problems.
After your surgery, the hospital staff will:
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
You will need to care for the incision site to prevent infection. You may experience a drop in calcium levels until the remaining glands adjust. Your doctor may advise taking a calcium supplement until the symptoms resolve.
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
If you think you have an emergency, call for emergency medical services right away.
American Academy of Otolaryngology—Head and Neck Surgery
Endocrine Diseases—The American Association of Endocrine Surgeons
Canadian Cancer Society
Canadian Society of Otolaryngology
Farndon JR. Surgical treatment: Evidence-based and problem-oriented. Postoperative complications of parathyroidectomy. Available at: http://www.ncbi.nlm.nih.gov/books/NBK6967. Accessed May 11, 2016.
Frequently asked questions about parathyroid surgery. Mount Sinai Hospital website. Available at: http://www.mountsinai.org/patient-care/service-areas/surgery/divisions/metabolic-endocrine-and-minimally-invasive-surgery/parathyroid/faqs-about-parathyroid-surgery. Accessed March 3, 2017.
Parathyroid surgery. American Association of Endocrine Surgeons website. Available at: http://endocrinediseases.org/parathyroid/surgery_overview.shtml. Accessed May 11, 2016.
Parathyroidectomy. Cedars-Sinai website. Available at: http://cedars-sinai.edu/Patients/Programs-and-Services/Head-and-Neck-Cancer-Center/Treatment/Parathyroidectomy.aspx. Accessed May 11, 2016.
Parathyroidectomy: minimally invasive (focused). University of California, Los Angeles Endocrine Surgery website. Available at: http://endocrinesurgery.ucla.edu/surgery_mip.html. Accessed May 11, 2016.
Sadik KW, Kell M, Gorey T. Minimally invasive parathyroidectomy using surgical sonography. Int J Med Sci. 2011;8(4):283-286. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085174/.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed June 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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