Your Parathyroid Operation

Your parathyroid operation with Mr Christakis

Mr Christakis will review all of the available information (your past medical history, symptomatology, biochemical results, scan results, body habitus) and formulate for you a personal/individualised operative plan.

No parathyroid operation is the same and every individual needs to have an operation that is tailored specifically to their needs.

Parathyroid operations can technically be very straight-forward and quick but they can also end up be very complex and lengthy in time. It is obvious that the more complex an operation, the higher are the surgical risks.

The reason for that is that sometimes the culprit parathyroid gland is hiding in positions that are outside the normal locations where they should be or they could be intimately related to key-vital structures (laryngeal nerves, carotid artery etc).

Mr Christakis offers the following parathyroid operations:

  • Bilateral neck explorations (non-localised/negative preoperative scans)
  • Parathyroidectomy for normocalcemic and normohormonal hyperparathyroidism
  • Redo-parathyroidectomy after previously failed neck exploration (persistent or recurrent hyperparathyroidism)
  • Minimally invasive parathyroidectomy
  • Parathyroid operation for suspected parathyroid cancer
  • Parathyroid operations for secondary/tertiary hyperparathyroidism.

Examples of patients that Mr Christakis has successfully treated in the past and demonstrate the complexity of a parathyroid operation

  • Culprit parathyroid gland hiding inside the thyroid gland hence a hemithyroidectomy was needed (removal of half of the thyroid gland)
  • Culprit parathyroid gland being very deep, next to the oesophagus (gullet)
  • Culprit parathyroid gland being next to the carotid artery
  • Culprit parathyroid gland being inside the thyrothymic ligament needing exploration/excision of the thyrothymic tracts
  • Presence of thyroiditis making the tissues around the thyroid gland very adherent
  • Presence of neck lymphadenopathy making identification of the parathyroid glands challenging
  • Parathyroid adenomas that had undergone infarction and were wrapped around the laryngeal nerve
  • Huge parathyroid adenomas/parathyroid cysts
  • Double parathyroid adenomas
  • 4-gland parathyroid hyperplasia requiring 3-and a half gland parathyroidectomy

Before the operation Mr Christakis will perform a fibreoptic nasoendoscopy (vocal cord check) to check that that your voice box works normally. It does not hurt and only lasts 1 minute.

During the operation, Mr Christakis uses a special device called nerve monitoring to check that the laryngeal nerves are working normally/have not been affected from the operation.

Mr Christakis can offer you a bilateral neck exploration or a minimally invasive parathyroidectomy:

1. Bilateral neck exploration (under general anaesthetic)

A bilateral neck exploration is aimed at looking everywhere in both sides of the thyroid gland and removing the culprit parathyroid gland(s).

2. Focused (targeted) minimally invasive parathyroidectomy (under general or local anaesthetic)

A focused parathyroidectomy is targeted at a specific region of the neck where the culprit gland is believed to be hiding.

Post-operative care and what to expect

The cosmetic result for both operations in both operations is excellent and when the wound heals it looks like a nice wrinkle at the base of the neck.

Mr Christakis stiches the skin just like the plastic surgeons and uses a special glue on top of it. You will not have any stiches on the outside, no drains (plastic tubes) and you do not need to have a dressing on top of your wound. All the stiches are on the inside and are self-absorbable.

You are allowed to eat and drink whatever you want straight after the operation. There are no restrictions to your mobility and you are free to move around as you wish. You might need some regular painkillers (paracetamol) if the wound is sore (Mr Christakis puts local anaesthetic to the wound while you are asleep to give you better pain relief).
You can return to your normal activities as soon as you feel like it.
After your discharge from the hospital, you will have a follow-up appointment (in the clinic or virtually-you will choose) with Mr Christakis to check that you are recovering normally. You will also have a blood test to confirm that all of your biochemical markers are back to normal. If everything is normal and you have been cured, you will be discharged back to your GP.