If you've been told you have the diagnosis of elevated calcium, hypercalcemia or likely have hyperparathyroidism, but you haven't been provided with a clear road forward, then this book is speaking to you.
The Patient's Guide to Hyperparathyroidism written by Dr. Lawrence Gordon, provides a step-by-step guide to help you navigate the decisions influencing your care when you have been diagnosed with hypercalcemia or hyperparathyroidism.
New testing and surgical techniques have dramatically changed the way parathyroid operations are performed.
We perform minimally invasive parathyroid surgical techniques. This is basically a more directed technique to remove the tumor based on accurate preoperative imaging and use of intraoperative parathyroid hormone assay. Minimally invasive parathyroid surgery is an outpatient procedure that requires just a small incision and can be performed in less than an hour. In addition, patients recover faster with minimal scarring.
We perform the latest in pre and post-operative testing techniques. Our parathyroid surgical techniques are minimally invasive, helping patients recover faster with minimal scarring.
Pre-operative Imaging
Preoperative parathyroid imaging and localization of the abnormal parathyroid tumor enables a minimally invasive or “mini-incision” approach to the parathyroid glands. Finding the tumor before incision allows us to make a smaller incision without the need to do a traditional neck exploration.
Testing For Elevated PTH during Parathyroid Surgery
We use a Parathyroid Hormone Analyzer for Rapid Intraoperative Parathyroid Hormone testing (IOPTH). The intraoperative PTH testing is performed on most patients undergoing parathyroid surgery. The purpose of the test is to ensure that there is a “chemical” cure to the hyperparathyroidism.
Intraoperative parathyroid hormone (IOPTH) monitoring is a relatively new test that has changed the way parathyroid surgery is performed. Intraoperative parathyroid hormone (IOPTH) monitoring is a test that we use to measure the parathyroid hormone level in the bloodstream before we remove the parathyroid adenoma and after we remove the parathyroid adenoma. If the parathyroid hormone level drops to 50% or more of its initial value within 10 minutes of parathyroid tumor removal, then this confirms the biochemical cure of primary hyperparathyroidism. This very specialized test is available at only a few medical centers.
Surgical Incision Location
At Advanced Parathyroid Surgery of New York we take pride in the quality of the work we do and the care we provide. We try to set realistic expectations when caring for our patients. Although scar length does matter, it is not the only consideration.
We base the location and length of the incision on the patient’s natural neck anatomy such as location of natural skin creases, location of the adenoma and the relation between the optimal incision location and the adenoma. In other words, there is no ‘one size fits all’ approach. Poorly placed “small” incisions can sometimes be cosmetically inferior. Our surgeon is a board certified head and neck plastic surgeon trained to provide the most aesthetic postoperative scar.
Length of the incision: Most of our minimally invasive incisions can be made with only a few centimeters in length. However, it is far more important to focus on the optimal cosmetic result.
Length of the Operation: Over 90% of our surgeries are completed in less than 60 minutes. This also enables a shorter hospital stay. However, the length of the procedure is less important than ensuring that your surgery is performed meticulously and safely. Patients with thyroid nodules or thyroidectomies (for issues unrelated to parathyroid disease) may have a longer procedure.
Length of Stay: Although most patients can go home the same day, we will not discharge a patient who needs observation. Safety and comfort are paramount.
