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Parathyroidectomy

What is a parathyroidectomy?

A parathyroidectomy is a procedure in which the surgeon removes part or all of your parathyroid glands.

When is it used?

The parathyroid glands make parathyroid hormone (PTH), which helps control the levels of calcium and phosphorus in the blood. Abnormal growth of these glands may increase the amount of PTH, which in turn can change the levels of calcium and phosphorus. As a result, your bones may become weak. In addition, you may develop kidney stones, weakness in your muscles, decreased alertness, depression, or stomach pain. This procedure is done when you have abnormal growth of some or all of these glands or if the glands are overactive.

An alternative is to choose not to have treatment, recognizing the risks of your condition. You should ask your healthcare provider about these choices.

How do I prepare for a parathyroidectomy?

Plan for your care and recovery after the operation. Arrange for someone to drive you home when you leave the hospital. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. Avoid medicines that may contain aspirin, such as nonprescription cold medicines. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.

Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

Follow any other instructions your provider may give you.

What happens during the procedure?

You will probably receive a general anesthetic. A general anesthetic will relax your muscles and put you to sleep. It will prevent you from feeling pain during the operation.

If you have had an abnormal gland identified by a nuclear scan (done in the X-ray department about 2 hours before the operation), the surgeon will use a probe that can find the "hot spot" seen on the scan. This will help the surgeon know where to make a small cut (incision) that the abnormal gland can be removed through. The cut is then closed and usually you can go home from the recovery room. This procedure is called a minimally invasive parathyroidectomy.

If no site can be identified by the scan, the surgeon will make a larger cut in your neck and expose the four parathyroid glands. The surgeon will remove glands or parts of glands that appear abnormal. The surgeon will sew the cut closed.

Sometimes all the glands are overactive. In this case about three and a half of the four glands are removed. The surgeon may decide to remove all of the glands and put very tiny pieces of one of the parathyroid glands in a cut in the arm just in the surface of a muscle. The area is marked with a small metal clip for easier future identification. Then it will be easier to take care of if the gland tissue becomes overactive again.

What happens after the procedure?

You may be in the hospital for about 1 or 2 days, depending on your condition. You may have some swelling in your neck and find that you have a sore throat and slight hoarseness. Your neck may tire out very easily for awhile, making it hard to hold up your head. You may need to take calcium to avoid having spasms in the muscles. You will have a scar in the front of your neck just above the breast bone.

Ask your healthcare provider what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

You will no longer have the kidney, bone, muscle, and mental problems created by a PTH level that is too high.

What are the risks associated with this procedure?

  • There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
  • The laryngeal nerves may be injured. These nerves allow you to speak normally. If they are damaged, the damage may be temporary or permanent, and your voice may be hoarse.
  • The original problem will persist if one of the overactive parathyroid glands is in an abnormal position and cannot be found. This condition is rare but it requires the surgeon to search those areas, usually in the upper chest.
  • Your wound may bleed and require attention. It may also become infected.
  • You may experience postoperative hypoparathyroidism (inadequate parathyroid function), including weakness, muscle spasm, and cardiac irregularities.

You should ask your provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

  • You develop a fever over 100°F (37.8°C).
  • You have uncontrollable muscle spasms.

Call during office hours if:

  • You have questions about the procedure or its result.
  • You want to make another appointment.
Developed by RelayHealth.
Published by RelayHealth.
Last modified: 2010-02-16
Last reviewed: 2010-03-15
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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