The range of endocrine surgery at the Pyramid Clinic includes surgery of the thyroid, parathyroid and adrenal glands. Complex findings are discussed with specialists in endocrinology, taking an interdisciplinary approach, and indications are determined together.
Range of treatments in thyroid surgery
- Thyroid surgery for benign changes/overactive thyroid
- Thyroid and lymph node surgery for thyroid cancer
- Minimally invasive video-assisted thyroidectomy (MIVAT)
Minimally invasive video-assisted thyroidectomy – MIVAT
Small nodules on the thyroid are common in young women. We offer minimally invasive video-assisted thyroidectomy (MIVAT) to meet the high cosmetic demands in these cases. With appropriate surgical expertise, this cosmetically favourable method can be used as an alternative to the classic throat incision. In this new endoscopically assisted method, the incision is reduced to a length of 2 to 3 cm and is barely visible if it correctly follows a skin crease.
Range of treatments in parathyroid surgery
- Surgical treatment of primary and secondary hyperparathyroidism
- Minimally invasive video-assisted parathyroidectomy (MIVAP)
- Reoperation for recurrent hyperparathyroidism
A highly specialised surgeon is required for successful parathyroid surgery. After resection of a parathyroid adenoma, normalisation of the PTH/calcium metabolism is assessed by collection of intraoperative blood samples and communicated to the surgical team in the operating theatre. The Pyramid Clinic provides the surgeon with another promising tool for monitoring the success of parathyroid surgery. By means of intraoperative fluorescence imaging using an infrared camera, overactive parathyroid tissue can be better distinguished from normal parathyroid tissue. This is a valuable technical tool that provides additional support to surgical expertise.
Maximum safety in operations on the neck – neuromonitoring
By using a latest-generation neuromonitor, which monitors nerve function during surgery with electromyography, the risk of injury to the laryngeal nerves controlling vocal cord function is reduced to a minimum. Problems with temporary hoarseness after surgery can thus be significantly reduced. In order to avoid damage to the parathyroid glands, which are embedded in the surface of the thyroid gland, imaging is used during the procedure and care is taken to ensure there is no injury to their blood supply. The risk of postoperative hypocalcaemia is estimated based on a parathyroid hormone test on the first postoperative day and calcium substitution may be begun, depending on the result. Emergency readmission due to tetany (involuntary muscle contraction) can thus be eliminated.
Range of treatments in adrenal surgery – laparoscopic adrenalectomy
Interventions on the adrenal gland are rare – so the expertise of the surgeon is all the more important. The most common indications for adrenalectomy are large incidentalomas of the adrenal glands and (usually small) active adenomas. In the case of active tumours, comprehensive preoperative diagnostics by an experienced endocrinologist are of the utmost importance. The endocrinologist coordinates the imaging and interventional radiological procedures based on the endocrine laboratory diagnostics. These days, adrenalectomies can almost invariably be performed laparoscopically. At the Pyramid Clinic our preference is for transabdominal access. The hospital stay and convalescence are comparable to that of laparoscopic cholecystectomy.