Your primary care doctor, endocrinologist or nephrologist may order blood tests to determine whether you have hyperparathyroidism. If hyperparathyroidism is diagnosed, an imaging study may be done to help find which of your parathyroid glands is overactive. Patients with hyperparathyroidism often require surgery, which is the only cure for primary hyperparathyroidism.
Our parathyroid surgeons are some of the highest-volume parathyroid specialists in the country in both first-time and reoperative parathyroid surgeries.
At Penn, we perform the following surgeries to treat hyperparathyroidism:
- Minimally invasive parathyroidectomy (MIP)
- Open parathyroidectomy, also known as a bilateral exploration
What to Expect During a Minimally Invasive Parathyroidectomy (MIP)
During a minimally invasive parathyroidectomy (MIP), we remove your affected parathyroid gland. We use an x-ray to pinpoint the the exact location of your tumor or tumors before surgery, which allows us to precisely remove one or more of your parathyroid glands using the smallest possible incisions.
If imaging tests don't show which parathyroid gland is overactive, we perform venous sampling. During venous sampling, a blood sample is taken from veins near each parathyroid gland to determine which one is making and secreting too much PTH.
MIP is typically an outpatient procedure and is performed under general or local anesthesia.
During surgery, we will measure your parathyroid hormone levels before and after the affected gland is removed to make sure your parathyroid hormone levels decrease. If they decrease, it signals that your remaining parathyroid glands are functioning properly. If your PTH levels do not decrease, we'll examine your remaining parathyroid glands and remove them as needed.
MIP offers several advantages when compared with an open parathyroidectomy, including less pain, reduced scarring and a shorter hospital stay. Most of the parathyroidectomies we perform here at Penn are minimally invasive.
What to Expect During an Open Parathyroidectomy (Bilateral Exploration)
Because the parathyroid glands aren't in the same place in everyone, they are sometimes difficult to find. If your affected parathyroid gland cannot be located before surgery, it will need to be identified and removed during surgery.
During an open parathyroidectomy, also known as bilateral exploration, we'll examine all four of your parathyroid glands — two on each side of your neck — and decide which parathyroid gland(s) to remove based on size, color and texture.
We always leave intact a portion of at least one parathyroid gland to ensure normal parathyroid function after surgery. General anesthesia is used in open parathyroidectomies, and you'll likely have to stay overnight in the hospital after the procedure.
Telemedicine Appointments Before and After Parathyroid Surgery
We offer telemedicine appointments both before and after your parathyroid surgery if your surgeon is a participating provider. Because hyperparathyroidism is diagnosed through blood testing, you will not need to visit us for a physical exam before surgery. If you are considered low-risk with no complications, we'll also be able to examine your surgical scar by video chat during a follow-up appointment.
We use video chat to try to make the surgery as convenient as possible for you. You'll only have to travel to Penn Medicine on the day of your surgery, but you can still remain well connected to your care team. Not all Penn Medicine providers offer telemedicine services. Please contact your provider to determine if he or she participates.