General Surgery

Parathyroidectomy

OPERATION: Parathyroidectomy (Right / Left / Bilateral)
ANAESTHETIC: General endotracheal anaesthesia
POSITION: Supine with neck extended

INDICATION:
[Primary hyperparathyroidism / multigland disease / recurrent hyperparathyroidism]. Preoperative imaging: USS [result], sestamibi scan [result], 4D-CT [result].

PROCEDURE:
WHO Checklist performed. Transverse cervical incision made. Platysma divided. Skin flaps elevated. Strap muscles retracted.

Thyroid lobe mobilised and retracted medially. Parathyroid glands identified systematically. Recurrent laryngeal nerve identified and preserved throughout.

TARGET GLAND(S): [Describe location — superior / inferior, right / left]. Enlarged gland [describe: weight estimation, macroscopic appearance]. Vascular pedicle identified and divided. Gland excised.

[If focused parathyroidectomy: intraoperative PTH measured pre-excision and 10 minutes post-excision — result confirmed >50% drop consistent with cure.]

[If bilateral exploration: all four glands identified and [describe — subtotal resection / total parathyroidectomy with autotransplantation].]

Haemostasis confirmed. Drain placed [if required]. Wound closed in layers. Skin subcuticular.

FINDINGS:
[Single gland adenoma / double adenoma / hyperplasia]. Abnormal gland weight [estimate].

SPECIMEN: Parathyroid tissue to histopathology.
EBL: Minimal. COMPLICATIONS: None.

POST-OPERATIVE INSTRUCTIONS:
Calcium levels monitored postoperatively. Patient informed of symptoms of hypocalcaemia. Oral calcium / vitamin D supplementation [if required]. Outpatient review with histology.