Minimally Invasive Parathyroidectomy (MIP)
Parathyroidectomy is the treatment of choice in symptomatic primary hyperparathyroidism. Minimally Invasive Parathyroidectomy cures fatigue and the bone, abdominal, urological, and mental symptoms associated with hypercalcaemia – parathyroidectomy also results in a quantifiable improvement in health related quality of life. Minimally invasive parathyroidectomy is reliable and safe and has become the first line treatment of primary hyperparathyroidism in specialist units in Australia, Europe and the United States.
When is minimally invasive parathyroidectomy possible
MIP is possible when an adenoma in one of the parathyroid glands is the cause for hyperparathyroidism. MIP has a 50% reduction in operating time, a shorter hospital stay, and a comparable clinical outcome with no notable difference in the type or number of complications – when compared with conventional neck exploration in large studies. Patients with multiple parathyroid gland disease are unsuitable for MIP surgery and require a conventional parathyroid operation.
Aims of Minimally Invasive Parathyroidectomy
After successful minimally invasive parathyroid surgery the PTH in the blood will return to an appropriate level and the calcium levels will return to normal.
Anaesthesia for MIP Surgery
- Minimally Invasive Parathyroidectomy is routinely performed under general anaesthesia
- The anaesthetic is given by a specialist Anaesthetist
- Modern anaesthesia is safe, however, rarely serious reactions to anaesthesia occur
- If you have ever had a reaction to an anaesthetic drug tell your Anaesthetist and Surgeon
- Your Anaesthetist will be able to explain which anaesthetic is best and the associated risks and benefits
MIP Surgery Scar
A horizontal skin incision is made in one of the lower neck skin creases over the culprit parathyroid gland. The incision is usually around 2cm long and is closed with dissolving sutures and then taped with micropore. With routine wound care including taping in the early post-operative period the scar usually settles to blend in with the skin creases.
Minimally invasive parathyroidectomy is usually performed as a day stay or overnight stay procedure. Most people recover fairly quickly after minimally invasive parathyroidectomy and resume normal activities within one week. A post-operative visit at two to three weeks is routine to review the results. You will need to contact the office to make an appointment for that visit.
Follow-up After Parathyroid Surgery
Generally follow-up after minimally invasive parathyroidectomy will consist of:
- A visit at 2 to 3 weeks for a wound check. You will need to contact the office to make an appointment for that visit
- Α final surgical review at 3 months
- Patients who require calcium supplements need to be seen by the Local Doctor on a weekly basis to have the blood calcium level checked and to have the calcium supplements progressively reduced
- Endocrinology review is needed 2 to 3 months after surgery for progress monitoring
- Your local doctor or endocrinologist may need to see you more frequently if there are any problems
- After successful parathyroid surgery the calcium level falls to normal very quickly
- A temporary drop in calcium levels below normal also sometimes occurs
- Symptoms of a low calcium level may include tingling around the mouth and in the hands, and, cramping (“tetany”) of the hands and feet
- Patients with a low calcium level after parathyroidectomy are usually sent home on calcium supplements and will need to see their local doctor every week to have the calcium levels monitored and calcium supplements managed
If you have any questions about minimally invasive parathyroidectomy, speak to your Local Doctor, who will arrange for you to see a thyroid surgeon.