We’ve Seen it All
The Norman Parathyroid Center practice is limited to parathyroid surgery only, and our seven surgeons are by far the most experienced parathyroid surgeons in the world. No other surgeons perform parathyroid surgery the way we do, or use our techniques. And in January 2022 we took the final step and have helped design and open the new Hospital for Endocrine Surgery–the world’s only hospital dedicated to surgery of the parathyroid, thyroid, and adrenal glands. This full-service hospital is home to the best endocrine surgeons in the world.
Unique Level of Expertise
Our operations are unique to parathyroid surgery performed elsewhere in the world in that we 1) examine all four parathyroid glands in nearly all cases, 2) determine the physiologic activity of each gland during the operation so that normal glands are not removed and all hyperfunctioning glands are appropriately removed, 3) compare each gland to the others prior to removal to account for variability seen in each patient, 4) have two extremely experienced parathyroid surgeons in every operation who are required to agree on the findings, 5) complete the entire procedure in most patients in under 20 minutes, 6) do not require endotracheal anesthesia in over 95%, and 7) allow nearly all to leave the hospital within 2 hours.
Normal Glands are Not Removed
Our unique assessment of the parathyroid gland’s activity (how much PTH is being produced by each gland) helps assure that abnormal (over-active) glands are removed, while helping prevent the removal of normal glands. There is no other method to accomplish these two critical components of successful parathyroid surgery.
Unfortunately for patients, the vast majority of surgeons will remove a parathyroid gland and then measure the PTH hormone in the blood to see if it decreases. If it does not, then they know the gland was normal (that they removed!) and they go find another gland to remove and repeat the process. This method guarantees that normal glands are removed in most cases and in some cases all of the normal glands are removed. This problem is becoming of epidemic proportions in the US as inexperienced surgeons perform this operation. About 10% of our practice is on patients who had a failed operation somewhere else, and about a third of them have lost their voice.
Check All Four — The Gold Standard Operation
It has long been known that the only way to achieve very high initial and long-term cure rates is to assess all four glands, but this is very difficult to do and requires many thousands of cases before a surgeon can accomplish this routinely—and why very few surgeons perform this gold-standard operation. Instead, nearly all surgeons chose to obtain localizing studies and then elect to remove only the gland that “shows” on the scan.
In contrast, scans used to “find” the bad parathyroid gland play little if any role in our operations because we examine and test all four glands routinely. Negative scan patients have the same operation at our Center and are often the “easiest” technical operations. Thus, we prefer patients have no localizing studies prior to referral. Because of our expertise and methods, our patients can expect complication rates below 0.5% and long-term cure rates over 99%–the best in the world.
Nobody learning to operate on you
Parathyroid surgery is a highly specialized field and we are the only surgeons in the world who perform parathyroid surgery only. It is important to understand that we have the exceptional results because of our experience and techniques (above), but also because we don’t allow surgeons in training to participate in our operations as all university hospitals do. Let’s face it, you didn’t travel a long way to have a surgical resident try to learn surgery on you!
Extremely High Cure Rates
Although our cure rates are over 99%–unquestionably the highest in the world, we cannot cure everybody. The anatomy of the parathyroid glands is so variable that even when we use the expertise of all three surgeons present every operative day we occasionally cannot find a gland. If you aren’t cured, we typically know it and will discuss this with you so you understand the problem and the potential solutions. We will follow along with you and find a solution–we almost always figure it out. It is a very rare patient that we cannot cure.