Parathyroid Surgery

The parathyroid glands are four small glands located just behind the thyroid gland. They secrete parathyroid hormone which is required for the normal regulation of blood calcium, which in turn ensures the normal function of many organ systems.

Parathyroid Adenomas & Hyperparathyroidism

When one or more parathyroid glands produces excess parathyroid hormone, it results in a condition called hyperparathyroidism. The most common cause of hyperparathyroidism is from a parathyroid adenoma, a benign tumor of one of the parathyroid glands. A solitary adenoma accounts for 85% of the cases of hyperparathyroidism, while the remaining 10 - 15% are from two more more abnormal glands. The excess parathyroid hormone results in an elevated blood calcium, which in turn has consequences on the many organ systems including the urinary, musculoskeletal, gastrointestinal, neurological and cardiovascular systems.

Some patients with hyperparathyroidism may be completely asymptomatic, or have very mild symptoms, being diagnosed only from a routine blood calcium evaluation. Symptomatic patients, however, may present with one or more of the following :

• Ureteric colic and kidney stones, from high urine calcium levels
• Bone pain, weak bones and pathological fractures from decreased bone mineral density / osteoporosis
• Abdominal pain from stomach ulcers and inflammation of the pancreas
• Neurological symptoms including fatigue, poor concentration and depression

Neck Ultrasound and Sestamibi-SPECT/CT

A neck ultrasound and a Sestamibi-SPECT/CT are the two most important investigations to detect and locate abnormal parathyroid glands.

Minimally Invasive Parathyroidectomy (MIP)

Surgery is the definitive treatment for hyperparathyroidism.

Accurate pre-operative localisation of a parathyroid adenoma allows us to perform a Minimally Invasive Parathyroidectomy through a small 2 - 2.5 cm neck incision. MIP is the gold standard treatment for parathyroid adenomas, the benefits of which include significantly less postoperative pain, faster recovery and an excellent aesthetic outcome. Parathyroid surgery, as for thyroid surgery, is very safe, with risks of voice damage of less than 1% when performed by an experienced parathyroid surgeon.

Dr Ranjiv performs one of the largest number of MIPs in the private sector.

Recovery from parathyroid surgery is generally very quick, with most patients going home on the day of surgery or after an overnight stay, with normal speech and swallowing, minimal pain or discomfort, and complete independent mobility.

Successful removal of the abnormal parathyroid gland cures the patient of the disease, and reverses many of the preceding harmful effects of excess parathyroid hormone.