Most "scarless" parathyroid surgeries in the U.S.; Pioneer of Minimally Invasive Surgery in the Western Hemisphere
better cosmetic quality-of-life vs. traditional surgery (related surgery)
Permanent voice changes in "scarless" surgeries
Suture to close 3 incisions that are each smaller than ¼ of an inch
Visión general
Paratiroidectomía «sin cicatrices» o paratiroidectomía transoral es una versión de la paratiroidectomía mínimamente invasiva (MIP) que se centra en la extirpación de una sola glándula paratiroidea y, al mismo tiempo, utilizar pruebas adicionales para garantizar que el paciente se haya curado. La principal diferencia es que no hay ninguna cicatriz visible, lo que significa que los desconocidos no te preguntarán qué cirugía te practicaron. Implica acceder a las glándulas paratiroides a través del labio inferior. Es una excelente opción para los pacientes que están preocupados por la apariencia estética de una cicatriz en el cuello o que desean mantener la privacidad de su salud.
El Dr. Russell ha realizado más cirugías de paratiroidectomía sin cicatrices que casi ningún otro cirujano del mundo.
Procedimiento
Durante la paratiroidectomía «sin cicatrices», el cirujano hace pequeñas incisiones en el interior del labio inferior para acceder a las glándulas paratiroides. Se utilizan instrumentos especializados para extraer las glándulas a través de estas incisiones. El procedimiento se realiza con anestesia general y, por lo general, dura unas horas. Esta técnica evita cualquier incisión externa y no deja ninguna cicatriz visible en el cuello. El procedimiento se realiza bajo anestesia general.
Beneficios y riesgos
El principal beneficio de la paratiroidectomía «sin cicatrices» es la ausencia de una cicatriz visible, lo que puede ser particularmente importante para los pacientes preocupados por la privacidad de su salud. Otros estudios han demostrado beneficios que incluyen un tiempo de recuperación más rápido y una reducción del dolor posoperatorio en comparación con la cirugía tradicional. Los posibles riesgos incluyen la infección, el sangrado y el daño a las estructuras circundantes, como el nervio laríngeo recurrente y otras glándulas paratiroides. Estos riesgos son similares a los asociados con la cirugía paratiroidea tradicional, y el cirujano los analizará detalladamente contigo.
Recuperación y seguimiento
La recuperación de una paratiroidectomía «sin cicatrices» suele ser la misma que la de la cirugía tradicional, y la mayoría de los pacientes pueden regresar a casa el mismo día. Las molestias leves en el labio inferior y el cuello son frecuentes y se pueden controlar con analgésicos de venta libre. Es importante seguir las instrucciones de cuidado posoperatorio para garantizar una cicatrización adecuada. Se programarán citas de seguimiento periódicas para controlar los niveles de calcio y garantizar el éxito de la cirugía.
Am I a Candidate?
Most patients qualify for scarless parathyroid surgery. Here's what matters.
Good candidates include patients with: hyperparathyroidism — who prefer no visible neck scar. This includes patients with a well localized single adenoma, but it also often includes patients in which no adenoma has been seen on other imaging. It even includes patients with conditions such as secondary or tertiary hyperparathyroidism.
Also (usually) eligible: Patients who have been told by another surgeon they are "not a candidate" — Dr. Russell evaluates these cases regularly and often finds scarless surgery is in fact possible. Often, patients with secondary hyperparathyroidism are also a candidate. Patients who previously had neck surgery may also be eligible on a case by case basis.
Benefits and Risks
The primary benefit of “scarless” parathyroidectomy is the absence of a visible scar. Similar to arthroscopic or laparoscopic surgery, “scarless” transoral parathyroid surgeon involves 3 small, hidden, incisions that are about ¼ of an inch in size and are closed with only one suture.
Most patients don’t choose scarless parathyroid surgery because of vanity. Instead, privacy or the desire to avoid being the center of unwanted attention is the driving motivation. This is especially true for our patients who are in a public-facing role or career such as politicians, actors, and even healthcare workers. While it is entirely appropriate to share your health information with whoever you want, there is an advantage in choosing when and how you share that information. Perhaps that is why the scar is the number one complaint of patients after thyroid surgery, with about 80% of patients expressing concerns about the appearance of their scar according to one study. You aren’t choosing scarless because you are vain: you are choosing scarless because you have more important things to worry about then repeating a story about your parathyroid gland dozens of times a day.
Benefits of "scarless" thyroid surgery according to some studies include a quicker recovery time and reduced postoperative pain compared to traditional surgery. There is less information regarding the absolute benefits of “scarless” parathyroid surgery, but there is adequate research to say that the risks of the traditional surgery with a visible scar are very similar to the risks of surgery without a visible scar when performed by an experienced surgeon. As the most experienced “scarless” parathyroid surgeons in the United States, your health is always our priority. If scarless parathyroid surgery is not right for you, we will let you know.
While at Johns Hopkins, Dr Russell extensively researched the topic of how scars impact a patient's quality of life, including approximately 100 papers, books and chapters on the topic. Ultimately, the results have consistently agreed: avoiding a neck scar improves the quality of life of most patients.
How It Works
Step 1 — Consultation: Dr. Russell reviews your imaging and evaluates candidacy. Same week consultation or virtual visits often available by request.
Step 2 — Surgery: Tiny incisions inside the lower lip. No neck incision. Can often have a chin or neck lift at the same time. 1–2 hours under general anesthesia.
Step 3 — Recovery: Most patients go home the same day. Potentially less pain than traditional surgery. Return to light activity within days.
Step 4 — Follow-up: Virtual or in-person. Out-of-town patients can complete entire process — consult, surgery, follow-up — in one trip.
Testimonials
"I get to decide who knows that I had parathyroid surgery.” -Patient
"I felt better while I was still in the recovery room.” -Patient
"Not even my family knows that I had parathyroid surgery.” -Patient
"I traveled from the other side of the world because I didn’t want to tell everyone about my personal information.” Dr Patient
Thyroid and parathyroid surgery —
while you stay awake.
For the right patient, we can treat your thyroid or parathyroid without general anesthesia. You stay awake and comfortable. You skip the grogginess. And you go home the same day.
Learn MoreFAQ
Q: Is scarless parathyroid surgery safe?
Yes, with an experienced team. Complication rates for TOEPVA at the Russell Center are equivalent to or lower than traditional parathyroid surgery. The unique risks are rare and typically resolve within days to weeks.
Q: Can scarless surgery be done for parathyroid cancer?
In most cases, no. Fortunately, parathyroid carcinoma(cancer) is very rare. We would usually (but not always) be able to have an idea if you might have parathyroid cancer based on your lab results before surgery.
How long is recovery from "scarless" parathyroid surgery?
Most patients go homethe same day and return to light activity within a few days. Full recovery is similar to traditional parathyroid surgery — typically 1–2 weeks. Some studies suggest that patients who choose "scarless" transoral thyroid surgery have less pain than other patients, although there is less information about scarless parathyroid surgery.
Do I need to travel to Columbia, MD for this procedure?
You will probably not be told fully about this approach if you do not talk to our team or one of the few experienced teams across the country. Many patients travel from across the U.S. and internationally. Consultation, surgery, and a follow-up visit can often be completed in a single trip. Virtual consultations and follow-ups are available. Most other surgeons in the United States are not very familiar with this technique at this time, or have done very few cases.
Another surgeon told me I'm not a candidate for “scarless” parathyroid surgery. Should I get a second opinion?
Yes. Dr. Russell regularly evaluates patients who were told they weren't candidates and frequently determines that scarless parathyroid surgery is, in fact, an option.
