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Dr Ben Lancashire is a specialist endocrine surgeon. He has expert training as a Specialist Parathyroid Surgeon in the surgical management of parathyroid gland disorders.
Treatment of hyperparathyroidism
Parathyroid surgery is the only effective treatment for primary hyperparathyroidism. There are no medications that can cure primary hyperparathyroidism.
For people without any symptoms, there are guidelines that may help you decide if you should consider surgery. Dr Lancashire will be able to discuss with you further whether you will benefit from surgery.
What are the options for parathyroid surgery?
Parathyroid surgery options include minimally invasive (targeted) parathyroidectomy and bilateral (four gland) exploration. The type of surgery required will depend on how many parathyroid glands are abnormal and how readily identifiable they are on pre-operative scans. When you consult with Dr Lancashire about your surgical options, he’ll provide guidance on which procedure (if any) is best suited for your circumstances and explain what you can expect after your surgery.
Minimally invasive parathyroidectomy involves removal of a single, clearly identified parathyroid gland via a small keyhole incision measuring approximately 2cm – 3cm.
Bilateral (four gland) exploration involves surgical inspection of both sides of the neck to remove one or more parathyroid glands via an incision that is slightly larger.
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 try to conceal the incision lines in any skin folds that you may have.
No surgery is without risks and/or potential side effects. Surgeons like Dr Lancashire, who are specifically trained in endocrine surgery, generally have lower complication rates associated with these 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 integrity monitor (NIM®) to help confirm and monitor the function of the important nerves that are at risk of injury during neck surgery. During consultations, he will explain what surgery he recommends for your condition and spend time discussing the risks that are associated with that operation.
Your first appointment with Dr Lancashire
On the day of your first appointment with Dr Lancashire, please arrive at the clinic 10 minutes early. This allows time to complete a New Patient Registration form.
At the first appointment you will discuss your condition, including a full medical history and examination. Sometimes a second appointment is needed for matters that require reflection on treatment options or additional testing.
Dr Lancashire will discuss your diagnosis and let you know if further appointments, surgery, or medications are recommended. If so, any questions you may have will be answered, and Dr Lancashire will liaise with your referring doctor.
Frequently asked questions
Are there other treatment options for hyperparathyroidism?
There are currently no treatment options besides surgery for primary hyperparathyroidism. For people without any symptoms, there are guidelines that may help you decide if you should consider surgery. Dr Lancashire will be able to discuss with you further whether you will benefit from surgery.
How long will I need to remain in hospital after surgery?
This will depend on the type of surgery you undergo. In some instances, patients may be able to go home in the evening, while others may need to stay overnight for observation.
Will there be scarring?
The surgical incision required for parathyroid surgery will generally leave a small scar. The size of the scar will depend on the procedure undertaken (minimally invasive versus bilateral exploration). Dr Lancashire can typically hide the scar amongst naturally occurring neck folds to achieve a cosmetically acceptable result. You will be given instructions on how to manage your scar after the surgery.
