TESTS AND PROCEDURES

Having Parathyroid Surgery

March 21, 2017

Having Parathyroid Surgery

Back view of thyroid showing parathyroids. You have 1 or more enlarged parathyroid glands. This can cause primary hyperparathyroidism. The parathyroid glands control the calcium level in your blood. Primary hyperparathyroidism causes high levels of blood calcium (hypercalcemia). This can lead to problems around your body. To treat the problem, the enlarged glands are removed with surgery. You may need one or more parathyroid glands removed. The decision about how many glands to remove is often made during surgery. Ask your healthcare provider for more information.

Risk and possible complications

The risks and possible complications of this procedure include:

  • Bleeding

  • Infection

  • Reaction to anesthesia

  • Thyroid gland problems

  • Injury to laryngeal nerves that affect the vocal cords

  • Failure to find the enlarged gland or glands

  • Need for more surgery

  • Low calcium and parathyroid levels (hypoparathyroidism)

Getting ready for surgery

After your surgery is scheduled, you’ll be told how to prepare. Follow all instructions, and be sure to ask questions as needed. Make sure to:

  • Tell your healthcare provider about any medicines you’re taking. This includes over the counter medicines, vitamins, and supplements. You may need to stop taking some medicines 1-2 weeks before surgery. These include aspirin and ibuprofen.

  • Follow any directions you are given for not eating or drinking before surgery.

  • Arrange for an adult family member or friend to give you a ride home after surgery.

The day of surgery

Arrive for surgery on time. Before going to surgery:

  • You’ll need to register. This may be done ahead of time during an earlier visit, online, or over the phone. Have identification and insurance information ready.

  • An IV (intravenous) line will be placed in a vein in your arm or hand. This is used to give fluids and medicines.

  • A healthcare provider or nurse will discuss with you what type of pain medicine (anesthesia) you will have during surgery.

During the surgery

  • An incision is made in your neck.

  • One or more enlarged parathyroid glands are removed. In some cases, all 4 glands are enlarged. When this happens, 1 and 1/2 of the glands may be removed. The remaining half gland often makes enough hormone to replace 4 normal glands. In rare cases, all of the glands are removed.

  • If all 4 glands are removed, part of 1 gland is then placed in another part in the body, usually in the neck or arm. This is called a parathyroid autotransplantation. The moved gland continues to work from this new place in the body.

  • When surgery is complete, the incision is closed with sutures (stitches), strips of surgical tape, or surgical glue.

After the surgery

Recovery from parathyroid surgery is usually quick. You may go home on the day of surgery or you may need to stay overnight. Once you’re ready to go home, you’ll be given instructions for how to care for yourself. Follow the instructions carefully. You may need to take vitamin D and calcium supplements after the surgery.

When to call your healthcare provider 

Call your healthcare provider if you notice any of the following during your recovery:

  • Numbness or tingling in the fingertips or around the mouth

  • Muscle cramping or spasms

  • Neck swelling

  • Fever of 100.4°F (38.0°C) or higher

  • Increasing redness, swelling, or fluid leaking from the incision site

  • Nausea or vomiting

  • Hoarse voice that worsens

  • Trouble breathing

  • Trouble swallowing

  • Irregular heartbeat

Updated:  

March 21, 2017

Sources:  

Morris. When is Surgery Indicated for Asymptomatic Primary Hyperparathyroidism? Laryngoscope (2009); 119(12); pp. 2291-2292, Up To Date. Parathyroid Exploration for Primary Hyperparathyroidism

Reviewed By:  

Freeborn, Donna, PhD, CNM, FNP,Hurd, Robert, MD