Adrenal
Adrenalectomy
Adrenalectomy is a surgical procedure that involves removing the adrenal gland, a small, triangular gland located at the top of the kidney. Our endocrine surgeons specialize in a minimally invasive approach called laparoscopic adrenalectomy. This type of surgery is performed through three or four incisions, each smaller than half an inch. The surgeon performs the operation using instruments placed through the small incisions.
Laparoscopic adrenalectomy takes approximately 1-2 hours to perform. The pain from surgery is mild and can typically be managed with oral pain medications. Patients usually resume a diet the evening after surgery. Depending on the tumor type, most patients will only require a one-night stay. Within about one to two weeks, most patients are back to their normal routine.
Thyroid
Thyroidectomy
A partial thyroidectomy or thyroid lobectomy is performed for patients with a suspicious or symptomatic nodule, or low-risk thyroid cancer.
Total thyroidectomy is performed for patients with a multinodular goiter, Graves’ disease, and more advanced thyroid cancer. Patients may also need removal of lymph nodes form the neck, called a neck dissection, if their thyroid cancer has spread.
Thyroid surgery typically requires an overnight stay. Patients are given a general anesthetic during the operation. A small incision is made in the front of the neck, typically placed in a skin crease that is approximately 2-3 inches in length. Depending the requirements of the thyroid disease, the surgeon will remove part of the thyroid or the entire thyroid gland.
Thyroid ablation with radioactive iodine (RAI)
Thyroid ablation with RAI is another treatment option for thyroid conditions. RAI ablation destroys hyperactive thyroid cells.
Parathyroid
Before treatment, patients meet one-on-one with their surgeon to review laboratory tests and diagnostic imaging, including ultrasounds, parathyroid scans and 4D CT scans.
Surgery is the primary treatment for primary hyperparathyroidism. Most people with this condition are candidates for parathyroidectomy. Parathyroid surgery is considered a safe and highly effective treatment for most parathyroid conditions.
Parathyroidectomy
Parathyroidectomy is a surgical procedure that involves removing one parathyroid gland.
In some cases, multiple parathyroid glands are affected. This may require a subtotal parathyroidectomy. In this procedure, up to three and a half glands are removed.
Washington University endocrine surgeons perform hundreds of surgeries each year. For parathyroid surgery, experience is critical for success. Parathyroid glands can be in unusual locations, where only an experienced, dedicated endocrine surgeon will be able to locate them.
Our surgeons also have significant experience in treating patients who have had prior parathyroid surgeries and require reoperative parathyroid surgery.
Parathyroid surgery is typically performed as an outpatient procedure. Patients are given a general anesthetic during the operation. The surgeon utilizes a small incision in the front of the neck, typically placed in a skin crease that is about 2 inches in length. After removing the parathyroid gland(s), the surgeon confirms the treatment has cured the problem by using intra-operative parathyroid hormone monitoring. This test takes about 30 minutes. The incision is closed with meticulous surgical technique to ensure the best cosmetic result.
If only one gland is removed, patients can typically go home after a brief period of observation. If more than one gland is removed, patients will stay overnight, usually in a private room.
Pain after parathyroid surgery is mild. Patients may experience a sore throat and mild neck discomfort around the incision. Most pain is easily treated with over-the-counter pain medicine. The incision will be covered with a steri strip, which is removed approximately 2 weeks after surgery. We employ a special wound care regimen that speeds healing and minimizes scarring. For many patients, it is difficult to see their incision 6 months after surgery.
Patients may also require a short course of calcium and vitamin D supplementation depending on how many parathyroid glands were removed during surgery. The regimen can last for about a month.
Multiple Endocrine Neoplasia (MEN) Syndromes
There are multiple types of treatments available for MEN syndromes. The type of treatment depends on the type of condition and which glands are affected. Most people with MEN syndromes will require adrenal, thyroid or parathyroid surgery. Our multidisciplinary team works to develop the proper treatment plan for each patient.
