Minimally Invasive or "mini" Parathyroid Surgery

Minimally invasive parathyroid surgery allows for simple identification and removal of abnormal parathyroid tissue with quick recovery and minimal scarring. In patients with hyperparathyroidism, there are elevated blood calcium levels. Elevated calcium levels often result in many vague symptoms. Calcium level blood tests are used to identify the problem and when there are elevated blood calcium levels, additional testing is done to identify the level of the parathyroid hormone level. Causes of hypercalcemia are always considered; however, with the identification of high parathyroid hormone levels and elevated blood calcium levels the diagnosis can be made of primary hyperparathyroidism. Elevated blood calcium levels can easily be treated with minimally invasive technique. Elevated parathyroid can be assessed with the use of an intraoperative blood test. Excess calcium in the blood can be also tested with a simple blood test.

When high blood calcium levels are identified, the symptoms associated with this should be assessed. High calcium effects result in vague symptoms. These symptoms are often overlooked and considered to be caused by stress or fatigue. High calcium symptoms include fatigue, mood changes, irritability, depression, and memory loss. High levels of calcium in the blood can also cause dyspepsia, a sensation of bloating, and a general ill feeling. High serum calcium is often associated with hyperparathyroid disorder and can also cause hypertension. Hyperparathyroidism treatment is essential for control of these symptoms.

In order to be more precise in identification of hypercalcemia, ionized calcium levels are used and measured against the ionized calcium range. The ionized calcium test is more accurate than serum calcium testing. Low serum calcium is an unusual finding and may be associated with a vitamin D deficiency. In most cases the high calcium levels are related to parathyroid disease and lowering blood calcium can be achieved by minimally invasive parathyroid surgery. In most cases, normal blood calcium levels are achieved.

Parathyroid care specialists often will offer minimally invasive parathyroid surgery at a Parathyroid Center. The minimally invasive surgery implies that the abnormal gland is identified prior to the surgery with the use of a nuclear medicine scan. With the combination of preoperative assessment as well as radio-guided surgery, determination can be made that only one of the glands is abnormal with a high degree of accuracy. If a single gland is identified to be abnormal, a very small incision is adequate to expose that single gland. The actual parathyroid gland is as small as a grain of rice. Once this small incision is made, radio-guided technology will identify the abnormal gland. This is done by intraoperative use of a small nuclear probe that identifies high levels of sestamibi within the parathyroid gland. Since the parathyroid gland selectively takes the injected nuclear material, the intraoperative use of the radio-guided probe leads the surgeon directly to this small abnormal gland. Removal of the gland and testing with a radio-probe confirms that it is a parathyroid adenoma. Actual removal of the gland often can be done in less than 15 minutes. In order to assure that the minimally invasive technique has cured the hyperparathyroidism, an immediate intraoperative parathyroid hormone level test is performed. The half life of parathyroid hormone is only three minutes and therefore in less than 10 minutes the parathyroid hormone levels have returned to normal. High blood calcium levels may take longer to return to normal but the parathyroid level reduction is an indication that the abnormal tissue has been removed. The hypercalcemia treatment is therefore often effective with this short minimally invasive procedure. The small incision is closed with a cosmetic technique to eliminate or minimize any scar. In minimally invasive surgery, the patients are given the option of going home right after the surgery or spending one night for observation. The minimally invasive technique is appropriate for patients with single-gland disease.