Parathyroid surgery

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Minimally invasive parathyroidectomy (parathyroid surgery) is an outpatient procedure that requires an incision of only a one-inch or less, and the procedure can be performed in less than half an hour.

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Parathyroid surgery

  1. 1. The New York Center for Advanced Parathyroid Surgery 15 Maple Avenue | Warwick, NY 10990 Toll Free: 888-760-0966Parathyroid SurgeryIn the medical profession, there is uniform agreementthat persons diagnosed with primaryhyperparathyroidism require surgery for removal of theabnormal parathyroid adenoma. You may not beexperiencing any of the common signs or symptoms suchas bone pain, kidney stones, or abdominal discomfort;nevertheless, the constantly elevated parathyroidhormone level is causing thinning of your bones andabnormally elevated calcium. Ultimately, this leads toosteoporosis, which may result in bone fractures in lateryears of life. The "wait" strategy is no longer considered areasonable option for most people.Traditional vs Minimally Invasive SurgeryThe traditional parathyroid operation techniquerequires a large incision in the neck to locate andexamine the four parathyroid glands located behindthe thyroid. The tumorous gland or glands are thenlocated and removed. Patients that opt fortraditional surgery require at least one night ofhospitalization. In the end, the patient is left with alarge inch scar on the neck.Minimally invasive parathyroidectomy is an outpatient procedure that requires an incision of only a one-inch or less, and the procedure can be performed in less than half an hour.Preoperative parathyroid imaging and localization of the abnormal parathyroid tumor enables aminimally invasive or "mini-incision" approach to the parathyroid glands. Finding the tumor beforeincision allows us to make a smaller incision without the need to do a traditional neck exploration. A2cm incision is made directly over the abnormal parathyroid gland. Because over 90% of patients withprimary hyperparathyroidism have a single parathyroid adenoma, its usually not necessary to exploreall four glands.The focused lateral mini-incision parathyroid surgery approach provides the most direct access to theparathyroid glands with a minimum of tissue manipulation. A 2cm incision is made directly over theabnormal parathyroid gland. Because over 90% of patients with primary hyperparathyroidism have aadvancedparathyroid.com Page 1
  2. 2. The New York Center for Advanced Parathyroid Surgery 15 Maple Avenue | Warwick, NY 10990 Toll Free: 888-760-0966single parathyroid adenoma (tumor of the parathyroid glands) it is not necessary to explore all 4 glandsin most cases. A successful preoperative parathyroid imaging localization of a single parathyroidadenoma is necessary for us to use this approach. In addition, the patients neck skin anatomy shoulddemonstrate that the lateral parathyroid surgery approach is aesthetically superior to a midline mini-incision. Each case is judged individually. In some cases, it is decided that the best parathyroid surgeryapproach is midline.The Midline Parathyroid Surgery ApproachThere are cases where we decide a mid-line incision would be more advantageous. If there are multipleadenomas, we use this parathyroid surgery approach as we may require access to visualize both sides ofthe neck. If preoperative imaging does not demonstrate the adenoma, we use this approach, as abilateral traditional neck exploration may be necessary. If there is concurrent thyroid disease or nodulesthat need exploration or surgical intervention, then we use a midline approach.Finally, the neck is bandaged and the patient is ready to go home. Because the operation is performedquickly and with limited dissection, patients can usually leave the hospital the same day. Overall pain isminimal, and the bandage is left in place for about a week.Parathyroid Surgery StepsThe overproducing parathyroid gland is made radioactive so it can be differentiated from the otherstructures in the neck. By using the Sestamibi scan, only the parathyroid tumor becomes radioactive.Now that the surgeon knows what general area to operate upon, the surgeon makes a small incision andonly operates in a small area of the neck.A miniature hand-held radiation probe is inserted into the incision to find the radioactive parathyroid.Then the surgeon dissects where there is greatest probe activity in the area of the overactiveparathyroid tumor.Once the tumor is removed, the surgeon measures the radioactivity in the parathyroid to make sure thatthe entire radioactive tumor has been removed. The surgeon will then determine whether moreoperating is necessary.Finally, the neck is bandaged and the patient is ready to go home. Because the MIRP operation isperformed quickly and with limited dissection, patients can usually leave the hospital the same day.Overall pain is minimal, and the bandage is left in place for about a week.advancedparathyroid.com Page 2
  3. 3. The New York Center for Advanced Parathyroid Surgery 15 Maple Avenue | Warwick, NY 10990 Toll Free: 888-760-0966Minimally Invasive ParathyroidectomyAt the New York Center for Advanced Parathyroid Surgery, we have the benefit of placing ouroperative suites next to our imaging facility enabling the ready use of the minimally invasiveparathyroidectomy technique.About 97% of parathyroid disease patients have only one bad parathyroid. So rather than use thetraditional parathyroid operation technique requiring a large neck incision to locate and examine thefour parathyroid glands, the MIRP surgical technique simply remove the one bad gland and leave theothers alone.Minimally invasive parathyroid surgery is an outpatient procedure that requires just a one-inch incisionand can be performed in less than half an hour. In addition, patients recover faster with minimalscarring.At the New York Center for Advanced Parathyroid Surgery, we perform the latest in minimally invasiveparathyroid surgical techniques. For more information about your parathyroid surgery treatmentoptions, visit www.advancedparathyroid.com.advancedparathyroid.com Page 3

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