This is an untouched photo of one of my patients at four months. I have many other photos with similar results. This early scar will continue to fade for two years.
Incision
There is much written about tiny incisions and minimally invasive surgery for hyperparathyroidism. The important issue is to have successful surgery. The final cosmetic result is excellent and within a year or two the incision is barely noticeable. I tailor the incision to the situation.
4D CT Imaging
This is the latest test available and it can be extremely helpful when the Sestamibi scan and ultrasound do not show the enlarged parathyroid (s)
Preop Imaging
If performed by an experienced ultrasonographer this test can be very helpful in locating the enlarged parathyroid (s).
Ultrasound
Localization Studies
There are different approaches to parathyroid surgery. I use the approach used by the vast majority of endocrine surgeons in the US.
Localization helps a minimally invasive focused operation to be performed along with intraoperative PTH testing.
Symptom Improvement Rate
Patients often ask how soon they can expect to feel better
These are rough guidelines.
Within one week:
- Fatigue
- Bone and Joint pain
Delayed:
- Muscle aches
- Sleep problems
- Heartburn
Effect of Surgery
And the good news is that surgery is very successful in treating these symptoms.
Adapted from Chan, Eigelberger: Ann Surg 2004
Muscle Strength
More evidence showing that muscle strength can improve after surgery for hyperparathyroidism.
Morris et al. Ann. Surg. 2012
GERD 6 months after PTx
Heartburn may be significantly improved after surgery for Hyperparathyroidism
| Preoperative | Postoperative | P value | |
| Overall score | 12.5 ± 1.3 | 4.5 ± 0.9 | <.0001 |
| Severity | 2.01 ± 0.20 | 0.84 ± 0.14 | <.0001 |
| Satisfaction | 2.16 ± 0.25 | 0.55 ± 0.14 | <.0001 |
Reiher Surgery 2012
Kidney Stones
Good news for patients who have the operation for kidney stones. The risk is very much reduced as shown in this graph.
Adapted from Mollerup BMJ 2002