Home > Who We Are > Big News for Removing an Enlar...

Big News for Removing an Enlarged Parathyroid

You've been told your parathyroid is enlarged. In a world where everything seems to be supersized, you're not surprised. The fact that you need surgery isn't a surprise either. The fact that you can have minimally invasive surgery on an outpatient basis at Montefiore Medical Center is a very pleasant surprise indeed.

What are parathyroid glands?

Your four parathyroid glands, located behind the thyroid gland in your neck, secrete a hormone called parathyroid hormone (PTH), which is critical in keeping the blood calcium level in your body within normal range. If calcium levels become too low, the parathyroid compensates by:

Releasing calcium from the bones
Conserving calcium that would ordinarily be excreted by the kidneys
Increasing absorption of calcium from food

What is hyperparathyroidism?

Hyperparathyroidism occurs when one or more of your parathyroid glands become enlarged, producing too much PTH causing a high level of calcium. It has many symptoms, some silent and some potentially harmful.

About 28 of every 100,000 Americans develop hyperparathyroidism every year. Twice as many women develop the disease, and incidences increase with age. For women over 60, new cases occur in approximately two out of every 1,000 diagnoses per year.

Introducing a minimally invasive procedure to remove an enlarged parathyroid

Removing an enlarged parathyroid gland is crucial to bone and kidney health. Removing it through minimally invasive surgery is critical to your overall health and well-being.

Our highly experienced surgeons, like Dr. Randall Owen, specialize in head and neck surgeries, and particularly in minimally invasive parathyroid surgery.

Traditional parathyroid surgery involves a long incision, 6 to 10 centimeters in length, in order for the surgeon to identify the enlarged gland. Typically 90 percent of patients only have one enlarged gland so most people undergoing traditional surgery are having a procedure that is way too big for them.

On the other hand, minimally invasive parathyroid surgery involves a much smaller incision, only 3.5 centimeters long. Why? Because surgeons are able to identify the enlarged gland before surgery, using a specialized scan. This allows the surgeon to avoid four-gland exploration in most cases, meaning no unnecessary incisions and less trauma to you, the patient. It also means a smaller scar.

After the surgeon removes the enlarged gland using this minimally invasive technique, he employs special technology to obtain a rapid intraoperative (while the patient is in the operating room) parathyroid hormone level on the patient. If the hormone level is within the normal range, which can happen within minutes of removal of an enlarged gland, the surgeon is assured that further surgical exploration is unnecessary. It's just one more way that we assure you're not undergoing a surgery that is too big for you.

Montefiore surgeons have a tremendous amount of experience performing minimally invasive parathyroid surgery, with highly successful outcomes.

We're also one of only a few hospitals in the New York metropolitan area to offer this procedure.

The biggest news for this small procedure

Patients receive a local anesthesia instead of general anesthesia
The surgery is performed as an outpatient procedure, which means the patient is able to go home in an hour or two after surgery versus staying in the hospital for 1 or 2 days
3.5 cm incision vs. 6 to 10 cm incision
Fewer complications
Less scarring
Less pain
Faster recovery; return to normal activities in a couple of days

Symptoms of Hyperparathyroidism

The most common symptoms of an enlarged parathyroid include: loss of appetite, thirst, frequent urination, lethargy, fatigue, muscle weakness, joint pains, and constipation. More severe symptoms may include nausea and vomiting, abdominal pain, memory loss, and depression.

Oftentimes a person with hyperparathyroidism has no symptoms, or they attribute their symptoms to other causes, and they first learn about the disease from blood tests taken during a routine visit to the doctor.

Patients with persistently elevated calcium levels due to overproduction of parathyroid hormone may also complain of bone pain. In the severe form, bones can give up so much of their calcium that the bones become brittle and break.

Other, more severe symptoms of hyperparathyroidism are the development of gastric ulcers and pancreatitis. High levels of calcium in the blood can be dangerous to a number of cells including the lining of the stomach and the pancreas causing both of these organs to become inflamed and painful (ulcers and acute pancreatitis).

Another common side effect for persistently elevated calcium levels is the development of kidney stones.

Call 718-920-4800 for more information or to make an appointment.