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Parathyroid Surgery

Surgery is the only effective treatment for hyperparathyroidism. There are no medications currently available that can cure primary hyperparathyroidism.   

For people without any symptoms, there are guidelines that may help decide if you should consider surgery. Dr Lancashire will be able to discuss if you will benefit from surgery.

What is the difference between a minimally invasive parathyroidectomy and a bilateral neck (four gland) exploration?

Prior to some of the newer advances in x-ray technology, abnormal parathyroid glands were more difficult to find. Fortunately, some people are now suitable for a parathyroid procedure called minimally invasive parathyroid surgery (MIPS). If you have a single, clearly identified parathyroid gland, Dr Lancashire may be able to perform the operation through a small keyhole incision measuring about 2cm-2.5cm. Otherwise, to look at both sides of the neck, you may require a bigger scar (of up to 5cm).

Dr Lancashire will explain what procedure is most suitable for you, and what you can expect after your surgery.

What are the risks of parathyroid surgery?

Parathyroid surgery is performed under a general anaesthetic. The parathyroid glands usually sit behind the thyroid gland. The thyroid is a butterfly-shaped gland that sits in the front of the neck. The size of the cut will vary depending on the location of the parathyroid, or if it has been identified clearly (localised) on radiological imaging.  Dr Lancashire will generally be able to conceal the incision lines in any skin folds that you may have.

No surgery is without risk or potential side effects. Surgeons like Dr Lancashire who are specifically trained in endocrine surgery have lower complication rates associated with those procedures than surgeons who don’t perform them on a regular basis.

The main risks specific to parathyroid surgery are:

  • A small fluid collection under the wound (seroma) (~5%)
  • Swelling or bruising (5%)
  • Failure to cure hyperparathyroidism (2 - 5%)
  • Bleeding or haematoma (blood clot) (<1%)
  • Wound infection (<1%)
  • Permanent voice hoarseness or weakness (<1%)
  • Needing long-term or permanent calcium replacement (<1%)

Dr Lancashire routinely uses a nerve monitor (NIM®) to help confirm and monitor the function of the important nerves that are at risk of injury during neck surgery. He will explain what surgery he recommends for your condition, and spend time discussing the risks that are associated with that operation.