A reoperative (“re-do”) parathyroidectomy is a surgical procedure that may be recommended if a patient’s initial parathyroidectomy was not successful. A parathyroidectomy is typically performed to cure hyperparathyroidism (parathyroid disease) and involves removing one, multiple or all diseased parathyroid glands.
People from across the globe travel to Tampa General Hospital’s Parathyroid & Thyroid Institute to consult with our award-winning and uniquely experienced parathyroid surgeons—Dr. Douglas Politz and Dr. José Lopez—who routinely perform reoperative parathyroidectomies for patients who received their initial surgery elsewhere. Equipped with the latest innovations in surgical care, Drs. Politz and López have performed more parathyroid operations than any other operating surgeons in the world.
Reasons for a Reoperative Parathyroidectomy
The parathyroid glands are tiny, rice-sized structures that are located behind the thyroid gland. Their precise locations within the neck can vary from patient to patient, and the abnormal gland (or glands) responsible for hyperparathyroidism are sometimes difficult to spot with the naked eye.
Removing all abnormal parathyroid glands should effectively cure hyperparathyroidism (including primary hyperparathyroidism and other types) and eliminate its symptoms. If a patient continues to have symptoms or the disease returns, however, a reoperative parathyroidectomy may be suggested to locate and remove any additional abnormal glands.
Reoperative Parathyroidectomy Procedure Details
The details of a patient’s reoperative parathyroidectomy will depend on his or her symptoms and the specifics of the initial surgery. Various imaging procedures will be performed to gain a better understanding of each remaining gland’s precise location within the neck and what abnormalities are contributing to the patient’s hyperparathyroidism. This may involve a benign growth that was previously missed, gland enlargement (hyperplasia) or—very rarely—parathyroid cancer.
What to Expect from a Reoperative Parathyroidectomy
A reoperative parathyroidectomy is often complex, as a surgeon must locate abnormalities that were previously missed and contend with hardened scar tissue from the initial operation. The overall success rates of reoperative parathyroidectomies range from 80% to 95%, with the skill of the surgeon playing a significant role in the procedure’s effectiveness.
Due to the distinct challenges of this operation, TGH is among only a handful of hospitals nationwide with the expertise required to perform reoperative parathyroidectomies. We ensure world-class outcomes by using advanced approaches like intraoperative nuclear mapping and radioguided technologies to confirm the exact location of each parathyroid gland prior to surgery. Furthermore, no surgical duo over the past 10 years has performed more parathyroid operations than Dr. Politz and Dr. López.