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Endocrine surgery

Endocrine surgery

Endocrine surgery

Bupa Cromwell Hospital’s endocrine surgery unit has been treating patients for over two decades, using the latest techniques to maximise the chance of a quick, successful resolution of thyroid disease.

Our endocrine surgeons work within a multi-discplinary team of specialists to provide the best possible service for the investigation, diagnosis and treatment of all endocrine surgical conditions. The team includes specialists in medical endocrinology, radiology, anaesthesia and pathology.

The lead surgeons also head up endocrine surgery units at high profile London teaching hospitals, and have been using laparoscopic ‘keyhole’ techniques for endocrine surgery for over 15 years.


two couples enjoying life

Endocrine conditions treated

Thyroid conditions

The thyroid gland, in the neck, produces a vital hormone called thyroxine. The gland may be overactive, under active, form nodules or enlarge to cause a swelling in the neck.

  • Swelling in the neck
    This may be diagnosed as goitre. Although most cases are benign, these can cause swallowing and breathing difficulties, and surgery may be required to remove some or all of the gland.
  • Single nodule in the gland
    This should be investigated as some are malignant thyroid cancers. This is done via ultrasound and MRI scans, and a biopsy is also taken. Treatment usually involves a combination of surgery and a dose of radioactive iodine if the nodules are malignant.

Our highly experienced thyroid surgeons perform very high numbers of these operations, and we offer the latest monitoring technology to ensure that the risk of nerve damage is minimal.

Parathyroid conditions

This is caused by high calcium levels due to primary hyperparathyroidism - an excess of parathyroid hormone (PTH) which is made by the parathyroid glands (near the thyroid gland). This can cause fatigue, renal stones, abdominal and joint pain, and pancreatitis.

Modern imaging techniques (including Spect CT and high resolution ultrasound) show the surgeon where the overactive gland is in the neck, after which a small incision is made to remove this. The PTH is measured during surgery to ensure that all of the excess is removed. The surgery has a 99% success rate.

Adrenal conditions

These are caused by a nodule or tumour making an excess of hormone in the adrenal gland (which makes hormones such as adrenaline and cortisol). Nodules in the adrenal gland can be found via CT or ultrasound imaging, and may be investigated to check levels of hormone production. A proportion of nodules are malignant but this is rare.

Adrenal nodules / tumours are usually removed via keyhole surgery. The operation takes around an hour and patients usually go home the next day.

Pancreatic disease

Whilst most patients with masses in the pancreas are treated by other surgeons at the Cromwell, a minority have tumours in the pancreas which secrete hormones such as insulin. These are normally treated by an endocrine surgeon.

Salivary (parotid and submandibular) disease

Patients may develop lumps, which are usually benign, in the submandibular and parotid glands. Investigation is normally by a combination of biopsy and MRI or ultrasound imaging, and treatment is via surgery to remove part of the gland (patients are usually able to leave hospital after 24 hours).

 

Ongoing follow up after surgery

Most endocrine patients are cured with surgery, but the hormone levels of the remaining glands need to be checked to ensure they are sufficient, and this can be done with a blood test. Some conditions may recur and patients can have further checks after surgery.

Patients with cancer detected in any endocrine gland will need careful follow up after surgery to ensure that the disease is in remission, and to provide early detection of recurrence to allow for prompt secondary treatment.

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