Parathyroid Surgery in Ankara, Turkey

Parathyroid surgery is a surgical procedure performed due to excessive hormone production or tumors developing in the parathyroid glands. In cases of hyperparathyroidism, this surgery is important for protecting bone health and regulating calcium balance.

Minimally invasive parathyroidectomy is a modern method performed through a small incision. Thanks to this technique, the operation time is shortened, the length of hospital stay is reduced, and recovery occurs faster. In addition, the risk of complications decreases.

Parathyroid surgery provides effective treatment especially for patients who experience kidney stones, bone loss, and muscle weakness due to high calcium levels. In this way, metabolic balance is restored.

After surgery, calcium and parathyroid hormone levels are monitored through regular follow-ups. Personalized dietary recommendations and lifestyle adjustments are of great importance for the long-term success of the treatment.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Parathyroid Surgery in Ankara, to get information about Parathyroid Surgery prices, the process, and the hospital where Parathyroid Surgery is performed.

What Is the Parathyroid?

The parathyroid is a structure consisting of four small glands located in the front of the neck, behind the thyroid gland. These glands secrete parathyroid hormone (PTH), which regulates the balance of calcium and phosphorus in the blood. Overactivity or underactivity of the parathyroid glands can lead to serious metabolic disorders affecting nerve and muscle functions, especially bone health.

What Is Parathyroid Surgery?

To better understand this surgery, it is first necessary to know what the parathyroid glands do. In our neck, hidden just behind the thyroid gland in front of the windpipe, there are usually four glands about the size of a lentil. These are the parathyroid glands. Although they are tiny, their function is vitally important. These glands secrete a substance called parathyroid hormone (PTH). PTH has one purpose: to keep the amount of calcium in our blood in a very delicate balance. Calcium is not only a mineral that provides hardness to our bones and teeth; it is also essential for our muscles to contract, our nerves to transmit signals, and our heart to beat in a regular rhythm.

In a healthy body, this system works perfectly. When blood calcium drops slightly, the parathyroid glands immediately detect it and secrete PTH to bring the calcium level back to normal. When calcium returns to normal, PTH production stops. However, sometimes this delicate balance is disrupted. One or more glands begin to secrete PTH continuously and excessively, acting as if calcium were low even though blood calcium is high. This condition is called hyperparathyroidism. Continuous exposure to high calcium over time leads to serious health problems. Parathyroid surgery means finding and surgically removing the overactive gland or glands that are the source of this problem and restoring the body’s calcium balance.

There are some main underlying causes of this uncontrolled activity. The most common situations are:

• A benign tumor in a single gland (parathyroid adenoma)
• Enlargement and overactivity of all four glands (parathyroid hyperplasia)
• Adenomas in more than one gland (multiple adenomas)
• Very rare parathyroid cancer

In Which Cases Is Parathyroid Surgery Performed?

The decision for parathyroid surgery is made by evaluating the effects the disease has on the body and the patient’s overall condition. Today, with widespread blood testing, many people can be diagnosed before they have significant symptoms. However, this does not mean the disease is harmless. Surgery is the most appropriate treatment option for both those with clear symptoms and those without symptoms but who meet certain risk criteria.

If hyperparathyroidism has begun to cause evident damage in the body, surgery is definitely necessary. These classic signs include:

Kidney-related problems.

• Recurrent kidney stones
• Calcification in kidney tissue
• Bone-related problems.
• Bone loss (osteoporosis)
• Fractures occurring with minor falls
• Widespread bone and joint pain

Digestive system-related problems.

• Nausea
• Vomiting
• Constipation
• Abdominal pain
• Neurological and psychiatric problems.
• Persistent fatigue and weakness
• Memory impairment
• Difficulty concentrating
• Depressive mood
• Anxiety

So, if none of these symptoms are present, why should surgery be done? Because hyperparathyroidism continues to silently damage the body in the long term. Therefore, even without symptoms, surgery is recommended for individuals who have one of the following conditions to prevent serious future problems.

• Being younger than 50 years old
• Blood calcium level being significantly above the upper limit of normal
• Osteoporosis detected on bone density measurement
• Early signs of decreased kidney function
• Very high urinary calcium excretion
• Detection of asymptomatic kidney stones on imaging studies

In summary, surgery not only resolves current problems, but also plays a protective role against serious risks such as heart disease, high blood pressure, and kidney failure that may develop in the future.

What Are the Risks of Parathyroid Surgery?

When parathyroid surgery is performed by an experienced surgeon in this field, it is an extremely safe procedure with a high success rate (95–98%). Still, as with any surgical intervention, there are some potential risks that should be known. Being aware of these risks helps you approach the process more consciously.

The main risks related to surgery are:

• Permanent low calcium
• Injury to the vocal cord nerve
• Bleeding
• Infection
• Failure of the surgery

Permanent Low Calcium (Hypoparathyroidism): The most common situation after surgery is a temporary drop in blood calcium levels. The reason is that after the problematic gland is removed, the remaining normal glands need some time to “wake up” and start working again. This is usually managed with calcium and vitamin D supplements and improves within weeks. However, in a very rare possibility (less than 1%), permanent low calcium may develop if all parathyroid glands are inadvertently damaged during surgery. In that case, lifelong medication is required.

Injury to the Vocal Cord Nerve: The parathyroid glands are very close to the nerve that enables movement of our vocal cords. Damage to this nerve during surgery may cause hoarseness. This is usually temporary and improves as swelling around the nerve subsides. The risk of permanent damage is below 1% in experienced hands and is one of the most feared complications of the surgery.

Bleeding (Hematoma): Accumulation of blood in the surgical area is rare (less than 1%) but serious. Swelling in the neck can compress the windpipe and make breathing difficult. Therefore, if sudden swelling in the neck and shortness of breath occur after surgery, urgent intervention is required.

Infection: Since the neck area has good blood supply, the risk of infection after these surgeries is very low.

Failure of the Surgery: Sometimes, despite surgery, the blood calcium level does not decrease. The most common reason is that the diseased gland is in an unexpected (ectopic) location and cannot be found, or that there is a second diseased gland that was not detected. In such a case, a second surgery may be required. The first operation performed by an experienced surgeon has the highest chance of success.

How Is Parathyroid Surgery Performed?

Parathyroid surgery can be performed with different approaches depending on the patient’s condition and the possibilities offered by technology. The main goal is always the same: to find and remove the overactive gland causing the problem. Today, two main surgical methods stand out.

• Minimally Invasive Parathyroid Surgery (MIP)

This is the most commonly preferred modern approach today. There is a basic requirement for this method to be applied: the location of the single problematic gland must have been precisely identified with pre-operative imaging tests (such as ultrasound, scintigraphy, or 4D CT). If the location of the problematic gland is clear like a map, the surgeon makes a small incision of about 2–3 cm in the neck to reach only that area. Through this small incision, the diseased gland is directly found and removed. The other normal glands are not touched at all.

This method has many advantages:

• Smaller surgical scar
• Less post-operative pain
• Shorter operation time
• Faster recovery and return to normal life
• Usually the possibility of same-day discharge
• Lower risk of complications

To ensure the success of this operation, a blood test called “intraoperative PTH measurement” is used. Ten minutes after the diseased gland is removed, the parathyroid hormone (PTH) level in the blood is measured. If the PTH level has dropped by more than 50%, this is evidence that the correct gland was removed and the surgery was successful. The procedure is concluded. If the drop is not sufficient, this means there may be another problematic gland, and the surgeon converts the operation to the traditional method and checks the other glands as well.

• Traditional Bilateral Neck Exploration

This is the classic method of parathyroid surgery and is still considered the “gold standard” in certain cases. It is preferred especially when the location of the problematic gland cannot be clearly found in pre-operative tests or when more than one gland is suspected to be diseased. The surgeon makes a wider incision in the lower part of the neck, identifies all four parathyroid glands on both sides one by one, visually examines them, and removes those that are abnormally enlarged. This approach provides the most comprehensive and reliable solution when the source of the problem is unclear. The surgeon will choose the most appropriate method based on experience and the patient’s condition.

Post-Operative Process After Parathyroid Surgery

Recovery after parathyroid surgery is generally quite comfortable and fast. Most patients return to normal life within a few days as the effects of the operation wear off. The post-operative process requires careful follow-up both in the hospital and at home.

What Should Be Expected in the Hospital?

After your surgery is completed and the effects of anesthesia wear off, you are taken to your room. These first hours and days are the beginning of your body’s adaptation to its new balance.

The steps awaiting you in the hospital are generally as follows:

• Pain control
• Starting nutrition
• Monitoring blood calcium levels
• Calcium supplementation

Mild pain at the surgical site, a feeling of tightness, and a mild sensation of catching when swallowing are normal. This can be easily managed with simple painkillers. After a few hours, you can start with liquids and then resume normal foods. The most critical follow-up is monitoring your blood calcium level. On the first day after surgery, blood is drawn at regular intervals to check your calcium level. A drop in calcium level is expected and this is normal. If calcium falls below a certain level or if you experience symptoms such as numbness or tingling, your doctor will immediately start oral calcium and vitamin D supplements. This is a natural part of the recovery process. Most patients are safely discharged on the same day or the next day after minimally invasive surgery.

Recovery Process at Home

Your recovery will continue after you return home. During this period, it is important to listen to your body and follow some simple rules.

• Activity: Rest is recommended for the first few days. You should avoid heavy lifting and strenuous sports for a week. However, light activities such as walking increase circulation and help your recovery.
• Wound Care: The surgical site is usually covered with a small bandage. Keeping this area dry and clean is sufficient. Your doctor will give you specific instructions regarding wound care.
• Medications: It is very important to use the calcium and vitamin D supplements prescribed when you leave the hospital regularly as instructed by your doctor. You should not stop these medications on your own or change the dose.

The post-operative process generally results in a noticeable increase in patients’ quality of life. Complaints such as long-term fatigue, pain, and mental fog gradually disappear over the following weeks.

What Those Who Have Undergone Parathyroid Surgery Should Pay Attention to

The period after successful parathyroid surgery is at least as important as the surgery itself. While your body adapts to its new calcium balance, there are some practical points you should pay attention to in order to get through this process smoothly and protect your health permanently:

• Be alert for signs of low calcium

In the early period after surgery, your blood calcium level may drop. Recognizing your body’s signals is very important. If you notice any of the following symptoms, you should inform your doctor immediately.

Numbness around the lips

Tingling in the fingertips

Numbness or pins-and-needles in the feet

Muscle twitching

Painful cramps in the hands or feet

• Do Not Miss Your Medications and Supplements

The calcium and vitamin D supplements prescribed by your doctor are the cornerstones of your recovery.

• Make sure to take your medications at the same times every day.

Taking calcium tablets with meals may increase absorption.

• Never stop your medication without consulting your doctor.

Your dose will be gradually reduced over time based on your blood tests.

• Do Not Neglect Your Follow-Ups

Regular post-operative check-ups are necessary to confirm the success of your treatment.

• Make sure to keep the appointment dates given to you.
• Have the requested blood tests (calcium and PTH) done on time.

These follow-ups help us adjust your medication doses and understand when your normal glands have taken over again.

Take Care of Your Surgical Scar

You can take a few simple steps to help the scar on your neck heal nicely.

• Protect your surgical scar from direct sunlight for the first six months.
• When going out in the sun, apply a high-factor sunscreen over the scar.
• After the wound is completely closed, you can use scar-reducing creams recommended by your doctor.

General Health and Lifestyle Recommendations

The period after surgery is a good opportunity to take better care of your overall health.

• Drink plenty of water.
• Try to eat a calcium-rich diet (dairy products, green leafy vegetables).

When your doctor allows, start exercises such as regular walking. This will help your bone strength increase again.

By following these simple but effective steps, you can get through the post-parathyroid surgery period comfortably and regain your health as soon as possible. Do not hesitate to talk to your doctor if you have any concerns.