What Is Parathyroidectomy?
Parathyroidectomy is surgery to remove parathyroid glands or parathyroid tumors. The parathyroid glands are right behind your thyroid gland in your neck. These glands help your body control calcium levels in the blood.
You will receive general anesthesia (asleep and pain-free) for this surgery. The surgery may last from one to three hours.
Usually the parathyroid glands are removed using a two- to four-inch surgical cut on your neck.
The cut is usually made in the center of your neck just under your Adam's apple. Your surgeon will look for the four parathyroid glands and remove any that are diseased. You may have a special blood test during surgery that will tell if all the diseased glands were removed. Rarely, when all four of these glands need to be removed, part of one is transplanted into the forearm.
The specific type of surgery depends on where the diseased parathyroid glands are.
Minimally invasive parathyroidectomy: You may receive a shot of nuclear medicine before this surgery. This helps highlight the diseased glands. If you have this shot, your surgeon will use a special probe to locate the parathyroid gland. Your surgeon will make a small cut (one to two inches) on one side of your neck, and then remove the diseased gland through it. This procedure takes about one hour.
Your doctor may recommend parathyroidectomy if one or more of your parathyroid glands is producing too much parathyroid hormone. This condition is called hyperparathyroidism. It is often caused by a small non-cancerous (benign) tumor called an adenoma.
Your doctor will consider many factors when deciding whether to do surgery and what type of surgery would be best for you. Some of these factors are your age, calcium levels in your urine and blood, and whether you have symptoms.
Before the Procedure
Parathyroid glands are very small. You may need to have tests that show exactly where your glands are. This will help your surgeon find your parathyroid glands during surgery. Two of the tests you may have are a CT scan and an ultrasound.
Before surgery, an anesthesiologist will review your medical history with you and decide what type of anesthesia to use. The anesthesiologist is the doctor who will give you the medicine that makes you asleep and pain-free during surgery and who monitors you during surgery.
Fill any prescriptions for pain medicine and calcium you will need after surgery.
Several days to a week before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), naproxen (Aleve, Naprosyn), and other drugs like these.
You will probably be asked to stop eating or drinking at least 6 hours before surgery.
Ask your doctor which medicines you should still take the day of surgery.
If you smoke, try to stop. Your recovery time will be shorter if you do not smoke. Ask your doctor or nurse for help.
Your doctor or nurse will tell you when to arrive at the hospital.
After the Procedure
Often, people can go home the same day they have surgery. You can start your everyday activities in a few days. It will take about 1 to 3 weeks for you to fully heal.
The surgery area must be kept clean and dry. You may need to drink liquids and eat soft foods for a day.
Numbness or tingling around your mouth in the 24 to 48 hours after surgery is caused by low calcium. You can take calcium supplements every 4 hours until the symptoms go away.
After this procedure, you should have routine blood tests to check your calcium level.
People usually recover very quickly after this surgery. Recovery is fastest when less invasive techniques are used.
Sometimes, another surgery is needed to remove more of the parathyroid glands.
Sosa JA, Udelsman R. The parathyroid glands. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 39.
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