en English
zh-CN Chinese (Simplified)en Englishid Indonesianvi Vietnamese
Call Us +65 6471 1233
CONTACT US Book Appointment
Dr. Tan Chuan Chien

Parathyroidectomy

A parathyroidectomy is a surgical procedure performed to remove one or more of the parathyroid glands. The parathyroid glands are small endocrine glands located near the thyroid gland in the neck. This procedure is primarily undertaken to treat hyperparathyroidism, a condition where one or more of the parathyroid glands become overactive, leading to elevated levels of parathyroid hormone (PTH) and subsequent calcium imbalance in the body.

Book An Appointment

Types of Procedure

There are different approaches to parathyroidectomy, including:

Minimally Invasive Parathyroidectom

A small incision is made to remove the affected gland(s) using advanced imaging and localisation techniques.

Video-Assisted Parathyroidectomy

Utilises a small camera and instruments through a small incision to perform the surgery with enhanced visualisation.

Pre-surgery Considerations

Before undergoing a parathyroidectomy, several important steps must be taken to ensure the surgery’s success and the patient’s safety. These pre-operative measures include:

  • Comprehensive Diagnostic Testing: Patients typically undergo extensive testing to confirm the diagnosis and determine the extent of the problem. This includes blood tests to check calcium and parathyroid hormone levels and imaging studies like ultrasound, Sestamibi scans, or CT scans to locate the abnormal glands.
  • Medical Adjustments: Manage conditions such as high blood pressure or diabetes to minimise surgical risks. Adjustments to medications, particularly those affecting calcium levels, may be necessary.
  • Dietary Restrictions: Patients may be advised to follow nutritional guidelines to stabilise calcium levels, including avoiding calcium supplements or certain over-the-counter antacids.

Indications for Parathyroidectomy

Parathyroidectomy is recommended for specific medical conditions related to the dysfunction of the parathyroid glands. Here are the primary indications for undergoing this surgical procedure:

  • Primary Hyperparathyroidism: One or more parathyroid glands are overactive, causing high calcium levels in the blood. This can lead to various health issues such as kidney stones, bone pain, and osteoporosis.
  • Secondary Hyperparathyroidism: Typically seen in patients with chronic kidney disease, this condition involves the parathyroid glands overcompensating for low calcium levels due to renal dysfunction.
  • Tertiary Hyperparathyroidism: This form develops after long-standing secondary hyperparathyroidism, typically in dialysis patients, where the gland(s) become autonomously hyperactive.
  • Parathyroid Cancer: Although rare, parathyroidectomy may be required if cancer is suspected or confirmed in the parathyroid glands.
  • Symptomatic Hypercalcaemia: Patients experiencing symptoms of high calcium levels, such as fatigue, muscle weakness, excessive thirst, and mental confusion, may require surgery if other treatments fail to normalise calcium levels.
DR. TAN CHUAN CHIEN

Key Guiding Philosophies

Competency

Dr. Tan is a Fellowship-trained Breast & Endocrine Surgeon who is registered on the Specialist Register (General Surgery) in both Singapore and Australia. He completed his formal Breast Surgery training through the BreastSurgANZ Fellowship Programme. He was previously Head, Division of Breast & Endocrine Surgery, NTFGH where he was the pioneer breast surgeon there developing a comprehensive, evidence-based Breast Surgery service.

Care for the wider community

Dr. Tan is passionate about engaging the wider community with regards to breast cancer outcomes. He volunteers with the Singapore Cancer Society and served as the Chairman of the Breast Cancer Awareness Campaign Committee from 2018 to 2021. He continues to currently serve as a member of this committee. During his time in the public hospital, Dr. Tan was involved in research on breast cancer screening and care, where he succeeded in obtaining competitive grants and managing a research team, with the overall aim to improve breast cancer outcomes in Singapore.

Patient-centered care

Dr. Tan believes in the importance of the patient experience and the partnership between doctor and patients in healing sickness. He also believes no two individuals are the same. He believes in the philosophy of personalised tailor-made care plans for each of his patients to meet their individual expectations and needs.

Comprehensive Breast, Thyroid and General Surgery service

Dr. Tan aims to provide comprehensive, evidence-based care to all his patients, in a modern equipped clinic along the entire spectrum of the patient journey from diagnosis, through treatment/surgery and aftercare.

As a supporter of personalised surgical care, I understand that no two patients are the same. I believe in tailoring management for each patient to meet each individual’s needs and expectations. A patient’s journey can be difficult and frustrating at times, so I strive to make this experience as pleasant and seamless as possible.

Dr. Tan Chuan Chien
For Singaporeans, Singapore Permanent Residents and foreigners

Medisave & Insurance Claims

Please speak to our friendly clinic staff about using your insurance plans.

*NTUC Income (Extended Panel)

Frequently Asked Questions

How long does it take for hormone levels to normalise after surgery?

Typically, parathyroid hormone (PTH) levels begin to normalise almost immediately after removing the hyperactive gland. However, it may take several weeks for all symptoms of abnormal calcium levels to resolve.

What dietary changes should I consider after a parathyroidectomy?

You may need to adjust your diet depending on how your calcium levels are affected. Some patients might need to increase their calcium intake, while others may be advised to restrict it.

Can parathyroidectomy affect my energy levels?

Many patients experience improvement in energy levels once their calcium and parathyroid hormone levels stabilise post-surgery. However, the initial recovery period may involve some fatigue as the body adjusts.

Dr. Tan Chuan Chien

Consultant General Surgeon Breast & Thyroid Surgery
  • Bachelor of Medicine & Bachelor of Surgery (MBBS)- The University of Adelaide, Australia
  • Fellow of the Royal Australasian College of Surgeons (FRACS)
  • Full Registration, Singapore Medical Council (SMC) and Specialist Accreditation Board, Singapore (General Surgery)
  • Full General & Specialist Registration (General Surgery), Australian Health Practitioner Regulation Agency (AHPRA)
  • Completed Breast Surgery training through the BreastSurgANZ Fellowship programme
  • Fellow of the Academy of Medicine, Singapore (FAMS)

Dr. Tan Chuan Chien is a Fellowship-trained Breast and Endocrine Surgeon practicing as a Consultant General Surgeon at Gleneagles Hospital, Singapore. He also sees patients at Mount Elizabeth Novena Specialist Centre and Parkway East Medical Centre. Dr. Tan is a registered Specialist Surgeon (General Surgery) in both Singapore and Australia.

Read Full Bio

Modern Facilities

We are equipped with modern and updated equipment, and a team that will take care of all your needs.

Accredited Specialist

Dr. Tan is a Fellow of the Royal Australasian College of Surgeons (FRACS). He is also accredited to practice as a Specialist in both Singapore and Australia.

Focused After Care

Dr. Tan firmly believes that transdisciplinary care is the key to every patient’s recovery journey.

Video-consultation for overseas patients

Dr Tan is available via video-consultations for patients who are not in Singapore.

Aftercare and Recovery

The recovery process following a parathyroidectomy ensures a smooth transition back to daily activities and minimises complications. Here’s what patients can typically expect during the aftercare and recovery period:

Immediate Postoperative Care

Patients are closely monitored in the recovery room immediately following surgery to manage pain and observe for any signs of complications. Most patients can go home the same day unless other concerns require overnight observation.

Pain Management

Mild to moderate pain and discomfort at the incision site are common, which can usually be managed with prescribed pain relievers or over-the-counter medications.

Wound Care

Instructions on how to care for the incision will be provided, including keeping the area clean and dry. Stitches or surgical glue that close the incision typically do not require removal, but follow-up appointments are important to ensure proper healing.

Activity Restrictions

Patients are advised to limit physical activity for several weeks, especially any that might stress the neck area. Normal activities can generally be resumed gradually based on comfort and healing progress.

Calcium Monitoring

Since the parathyroid glands regulate calcium levels, it is important to monitor these levels after surgery. Some patients may experience temporary or permanent hypocalcaemia (low calcium levels) and need calcium and vitamin D supplements to help maintain normal levels.

Follow-Up Visits

Follow-up appointments are necessary to monitor recovery, evaluate calcium and parathyroid hormone levels, and address any symptoms or concerns. These visits also provide an opportunity to discuss the results of the pathology report and any further treatment needed.

The Procedure of Parathyroidectomy

Parathyroidectomy is a delicate surgical process that involves the removal of one or more parathyroid glands. Here’s how the procedure is typically performed:

Anaesthesia

The patient is administered general anaesthesia to ensure they are asleep and pain-free during the surgery. An intravenous (IV) line is placed to administer medications, and the patient is connected to monitoring equipment to track vital signs.

Incision

A small incision is made in the neck to access the parathyroid glands.

  • In a Minimally Invasive Parathyroidectomy, this incision is very small and strategically placed.
  • In a Video-Assisted Parathyroidectomy, the incision allows for the insertion of a small camera and surgical instruments.

Exploration and Localisation

The surgeon uses preoperative imaging studies for Minimally Invasive Parathyroidectomy, such as a Sestamibi scan or ultrasound, to accurately locate the overactive parathyroid gland(s). For Video-Assisted Parathyroidectomy, the camera provides a magnified view of the surgical area, aiding in precise identification of the glands.

Gland Removal

The surgeon carefully dissects around the identified gland(s) and removes the overactive parathyroid tissue. In cases where all four glands are overactive, part of the remaining glands may be reimplanted in another location, such as the forearm, to maintain some parathyroid function.

Intraoperative PTH Testing

During the surgery, intraoperative PTH testing may be performed to confirm that the overactive gland(s) have been successfully removed. A rapid drop in PTH levels indicates successful removal.

Closure

The incision is closed with sutures or surgical glue, ensuring minimal scarring. A sterile dressing is applied to the incision site to protect it during the initial healing phase.

Potential Complications and Risks

Although parathyroidectomy is a generally safe procedure with a high success rate, like any surgical intervention, it carries potential risks and complications. Patients should be aware of these possible issues:

  • Hypocalcemia: The most common complication after parathyroid surgery is hypocalcemia or low blood calcium levels. Symptoms include tingling in the lips and fingers and muscle cramps.
  • Recurrent Laryngeal Nerve Injury: This nerve, which passes close to the thyroid gland, can be damaged during surgery, potentially leading to voice changes or hoarseness. This complication is usually temporary but can be permanent in rare cases.
  • Bleeding and Infection: As with any surgical procedure, there is a risk of bleeding and infection, although these are relatively rare in parathyroid surgery.
  • Persistent or Recurrent Hyperparathyroidism: There’s a chance that hyperparathyroidism may persist or recur if not all the hyperactive glands are successfully removed, or if additional hyperactive parathyroid tissue was not identified during surgery.
  • Thyroid Dysfunction: Because of the proximity to the thyroid gland, the surgery may inadvertently affect thyroid function, requiring monitoring and potential treatment post-surgery.

Our Clinic

LET’S GET IN TOUCH

Make an enquiry with us!

Get Started

Please fill up this form and we’ll get back to you shortly!

    For quicker response, call us at +65 6471 1233
    Chat with our friendly clinic staff through WhatsApp!
    MAIN CLINIC

    SOG - CC Tan Breast, Thyroid & General Surgery

    OTHER PRACTICE LOCATIONS

    SOG - CC Tan Breast, Thyroid & General Surgery
    (Mount Elizabeth Novena)

    SOG - CC Tan Breast, Thyroid & General Surgery
    (Parkway East)

    MAIN CLINIC

    SOG - CC Tan Breast, Thyroid & General Surgery

    OTHER PRACTICE LOCATIONS

    SOG - CC Tan Breast, Thyroid & General Surgery
    (Mount Elizabeth Novena)

    SOG - CC Tan Breast, Thyroid & General Surgery
    (Parkway East)