Parathyroidectomy is surgery to remove enlarged parathyroid gland(s). We generally have four parathyroid glands which are located behind the thyroid gland in the neck. It is responsible for regulating calcium level in the blood.

Parathyroidectomy may be recommended for a number of conditions:

Parathyroid adenoma
This is a non-cancerous tumour of one or more parathyroid gland leading to elevated blood calcium levels. It may produce almost no symptoms, but can also cause issues like memory loss, abdominal pain, bone pain, osteoporosis, kidney stones and constipation.

Four glands hyperplasia
This is the enlargement of all four parathyroid glands, most often due to underlying kidney problems. It can cause severe bone and joint pains. If it cannot be controlled by medication, removing all and reimplanting a portion of the parathyroid gland may be an option.

The type of surgery recommended will depend on the location of the involved parathyroid gland(s) and the number of glands that need to be removed. The surgery will be carried out under general anaesthesia and the procedure will take between one to two hours to complete. Most patients can eat and drink after the surgery and go home the following day.

Minimally invasive parathyroidectomy (MIPs)
The affected gland will have been localised with a nuclear medicine or 4D CT scan when you see your specialist. During surgery a small cut is made on one side of the neck and the diseased gland is removed through it. The procedure will take approximately an hour.

Four gland exploration
If the gland cannot be localised with a scan before surgery or all 4 glands need to be removed, a larger cut will need to be made. It will often take about two hours.

Risks specific to parathyroidectomy are:

  • Bleeding
  • Infection
  • Airway problems due to bleeding - this will require return to the operating theatre within 24 hours of surgery
  • Temporary/ permanent hoarse or weak voice due to nerve damage
  • Low calcium level needing calcium replacement
  • Thickened scar on the neck
  • Further surgery if the affected gland cannot be identified or the blood calcium level remains high

 

Video of a Parathyroidectomy
(courtesy of the Norman Parathyroid Center).