Information About Parathyroid Surgery

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Dr. Craig Andersen, M.D., F.A.C.S 

Dr. Andersen specializes in performing the Minimally Invasive Parathyroidectomy for the surgical treatment of primary hyperparathyroidism. Dr. Andersen has performed hundreds of parathyroid surgeries over the course of more than 20 years, and has a cure rate in primary hyperparathyroidism of 97%. Regardless of where in the United States you have your surgery, parathyroid operations either focus on a single abnormal parathyroid gland detected by radiology, or they involve exploring all four parathyroid glands. Dr. Andersen performs both types of operation using the same 1 to 1.5 inch cosmetic incision. Nearly all patients can go home the same day as their operation. Dr. Andersen approaches each patient as an individual. The recommended surgical plan is based on a comprehensive evaluation including blood testing, the latest imaging technologies, and, most importantly, a face to face consultation with the patient.

What are the parathyroid glands?

The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland. Most people have four parathyroid glands, two on each side. Normal parathyroid glands are very small, averaging about one half the size of a pea. Parathyroid glands may be located in unusual positions, and in some cases can be challenging to find.

What is the function of the parathyroid glands?

The body wants to maintain a normal level of calcium, which is involved in the function of our nerves, muscles, and almost every other system. The normal function of the parathyroid glands is to release parathyroid hormone when the calcium level in the blood is too low. Parathyroid hormone causes calcium to be released from the bones into the blood, which raises the blood calcium level back to normal.

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What is Primary Hyperparathyroidism?

Primary hyperparathyroidism occurs when one or more parathyroid gland becomes enlarged and hyperactive. About 80-90% of cases involve just one parathyroid gland. 10-20% of cases involve 2, 3, or all 4 parathyroid glands. The cause is unknown. Enlarged, hyperactive parathyroid glands inappropriately release too much parathyroid hormone. This causes the blood calcium to be too high – a condition called hypercalcemia. Hypercalcemia is sometimes asymptomatic, but patients with primary hyperparathyroidism often have one or more symptoms including: severe fatigue, trouble concentrating, forgetfulness, depression, excessive aches and pains, and abdominal discomfort. Primary hyperparathyroidism can also cause complications, such as kidney stones or osteoporosis.

How is primary hyperparathyroidism treated?

Surgery represents the only cure for primary hyperparathyroidism, and is recommended for most patients. Surgery involves identifying and removing the abnormal parathyroid gland or glands, while preserving the normal parathyroid glands. The parathyroid function and calcium level will return to normal by the next day. Symptoms usually improve within days. In some cases, especially if the patient is asymptomatic, a “watch-and-wait” approach, rather than surgery, may be appropriate.

Information About Thyroid Surgery.

What is the thyroid gland?

The thyroid gland is a butterfly-shaped organ located in the base of your neck. The thyroid gland is about 2-inches long and lies in front of your throat below the prominence of thyroid cartilage sometimes called the Adam’s apple on men. The thyroid has two sides called lobes. The two lobes are connected across the middle by a strip of thyroid tissue known as the isthmus.

What is the function of the Thyroid gland?

The thyroid constantly releases a steady amount of hormones into your bloodstream that control your body’s metabolism or the way your body uses energy. The thyroid’s hormones regulate vital body functions, including breathing, heart rate, central and peripheral nervous systems, body weight, muscle strength, menstrual cycles, body temperature, and cholesterol levels. Routine wellness visits to your primary care physician are important as typical blood tests done at these visits could reveal an issue with your thyroid.

The most common thyroid diseases are briefly listed below:

Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. Hyperthyroidism is usually first treated with medicine. Surgery is sometimes used for a long term cure.

Hypothyroidism is a disorder where the thyroid does not produce enough thyroid hormone. Hypothyroidism is treated with medicine, not surgery.

A Thyroid Nodule is a lump or abnormal growth on the thyroid gland. Most nodules are benign, but they can be thyroid cancer. It is sometimes safe to leave a thyroid nodule in place. Other times, surgery to remove the nodule is recommended.

A Multinodular Goiter is the abnormal enlargement of the thyroid gland with multiple lumps together. Sometimes these goiters make too much hormone and cause hyperthyroidism. They can also sometimes cause pressure symptoms because of their size. Multinodular goiters are often treated with surgery if they are causing problems.

Grave’s Disease, also known as diffuse toxic goiter, is an autoimmune disease of the thyroid tissue that causes enlargement of the thyroid and hyperthyroidism. Grave’s disease can be treated with either medicine or surgery.

Surgical options include:

Thyroid lobectomy – Complete removal of one lobe of the thyroid.

Total thyroidectomy – Complete removal of the thyroid gland.

Partial lobectomy – Partial removal of one lobe of the thyroid.

Lymph node dissections – removal of lymph nodes in the neck, sometimes needed in thyroid cancer.

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