Removing the Parathyroid Glands

Parathyroidectomy is an operation to remove one or more of the four parathyroid glands in your neck. It is the main treatment for primary hyperparathyroidism and for some cases of secondary or tertiary hyperparathyroidism.

• High blood calcium (hypercalcaemia) causing symptoms or complications
• Kidney stones or kidney damage
• Bone thinning (osteoporosis) or fractures
• Unexplained tiredness, mood changes, abdominal pain, or frequent urination linked to high calcium
• Secondary hyperparathyroidism that does not respond to medicines, especially in kidney disease
  

• Minimally invasive (focused) parathyroidectomy – removal of a single overactive gland through a small neck incision.
• Bilateral neck exploration – the surgeon checks all four glands and removes any that are overactive.
• Video‑assisted or endoscopic approaches – less common, using small cameras for even smaller scars.
  

• Pre‑op blood tests (calcium, PTH, vitamin D, kidney function) and ECG if needed
• Scans to locate the overactive gland(s) – ultrasound and Sestamibi scan or CT
• Discuss your medicines – you may need to stop blood thinners temporarily
• Fast (no food) for 6 hours before surgery, clear fluids up to 2 hours before (follow hospital instructions)
• Arrange transport home and help for a few days after the operation
  

You will have a general anaesthetic (you will be asleep). A small incision is usually made at the lower front of the neck. The surgeon identifies and removes the overactive gland(s). Sometimes a small drain is placed; it is usually removed before you go home.

• Bleeding or haematoma in the neck (rare)
• Infection of the wound
• Temporary or permanent hoarse voice (injury to the recurrent laryngeal nerve) – about 1–2 %
• Low calcium levels (hypocalcaemia) causing tingling or cramps – usually temporary
• Scar – typically small and fades over time
  

• Most patients go home the same day or after one night in hospital.
• You may have a sore throat and mild neck discomfort; simple painkillers help.
• Blood calcium will be checked within 24 hours and again at follow‑up.
• You may need calcium or vitamin D tablets for a short time.
• Keep the wound dry for 48 hours, then shower as normal; avoid soaking in baths for one week.
  

• Most people return to normal activities within 1–2 weeks.
• Avoid heavy lifting or strenuous exercise for about 2 weeks.
• Gentle neck stretches can help stiffness (ask your nurse for advice).
• Protect the scar from sunlight for the first year to help it fade.
  

• Clinic appointment 2–6 weeks after surgery to review calcium and PTH levels.
• Long‑term blood tests (usually yearly) to monitor calcium.
• Bone density scans may be repeated to check bone health.

• Sudden swelling or bleeding at the incision site
• Difficulty breathing or swallowing
• Tingling around the lips or in hands/feet, or muscle cramps that do not improve with calcium tablets
• Fever, increasing redness, or discharge from the wound
  

• Parathyroid UK – www.parathyroiduk.org
• British Thyroid Foundation – www.btf-thyroid.org (parathyroid section)
• NHS website – www.nhs.uk