Pearls You Should Know about Hyperparathyroidism

• 90% of the time hyperparathyroidism can be cured with the surgical removal of a single parathyroid gland.

• 10% of the time, several parathyroid glands are enlarged and the removal of one gland will not be curative.

• When your minimally invasive parathyroid surgeon only uses the Sestamibi parathyroid probe to find your parathyroid tumor(s), he/she runs the risk of performing a non-curative surgery 10% of the time, because this technique is not effective in the detection of more than one parathyroid tumor.

• Use of intra-operative rapid PTH monitoring is the only reliable technology available for documenting parathyroid surgical success in the operating room.

• Most hospital x-ray technicians are not experienced enough to recognize parathyroid shadows on neck ultrasound. Thus, the likelihood that your parathyroid tumor will be noticed by a hospital x-ray technician is small. 

• Virtually all hospital neck ultrasounds are performed by technicians and subsequently interpreted by radiologists. At Ft. Lauderdale Endocrine Surgery, Dr. Harrell is neck- ultrasound certified and has a vested interest in locating your abnormal parathyroid glands.  He looks harder and has the time and expertise necessary to find enlarged glands because he is DIRECTLY RESPONSIBLE for your parathyroid care.

• Radiologists can only interpret the pictures that are presented to them.  If their ultrasound technicians do not notice parathyroid tumors while they are performing scans, the radiologist will miss them when he reviews the pictures.

• Not everyone with hyperparathyroidism should have surgery.  In fact, many high risk patients, like those with renal failure, are best treated with medication.  Endocrinologists are the only sub-specialists trained in making the difficult decision as to which patients should have parathyroid surgery.  ARE YOU WILLING TO LET SOMEONE OTHER THAN AN ENDOCRINOLOGIST MAKE YOUR SURGICAL DECISION FOR YOU?

• Most General Surgeons and ENT surgeons perform less than 12 parathyroid surgeries in a given year.  ARE YOU WILLING TO LET A SURGEON WHO DOES LESS THAN ONE PARATHYROID SURGERY A MONTH DO YOUR SURGERY?

• Most General Surgeons and ENT surgeons perform parathyroid surgery through a 3-5 inch incision across the neck, using only their hands and eyes to find all four parathyroid glands.  This surgery requires cutting skin and two muscle layers and then dissecting and lifting the thyroid up so that all four glands can be visualized.  The typical duration of surgery is 2 hours.

• A properly executed MIRP surgery with intra-operative PTH testing carries a very high likelihood of being permanently curative as well as cosmetically acceptable.  MIRP procedures typically require less than 30 minutes of operating room time.
• Patients often go home or back to their hotel rooms after the surgery is complete and the anaesthesia has worn off.

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