Conditions We Treat
The parathyroid glands are four pea-sized endocrine glands located on the back side of the thyroid in the neck. Though their names are similar, the thyroid and parathyroid glands are entirely different glands, each producing distinct hormones with specific functions. Parathyroid glands secrete a hormone called parathyroid hormone (PTH) which regulates the amount of calcium and phosphorus that circulates through the blood. Occasionally, one or more of these glands becomes enlarged and produces excessive amounts of parathyroid hormone. The extra parathyroid hormone causes bones to dissolve and raises the blood calcium level. This disease is called primary hyperparathyroidism.
Minimally Invasive Parathyroid Surgery (Minimally Invasive Radio-Guided Parathyroid (MIRP) Surgery)
Successful surgical treatment of hyperparathyroidism not only requires sophisticated technology and specialized skills, but also teamwork between the endocrinologist and endocrine surgeon. Dr. Harrell and David Bimston, MD, of the Memorial Center for Integrative Endocrine Surgery, have pioneered a coordinated and multidisciplinary approach for the evaluation and removal of parathyroid tumors, using minimally invasive techniques.
Minimally invasive radio-guided parathyroid surgery has a 95 percent success rate and is associated with a low risk of injury to other neck structures. The surgical procedure is performed through a 1-inch incision that heals quickly during recovery. The operation rarely takes longer than an hour or requires an overnight stay. Through the use of intra-operative parathyroid hormone testing, Dr. Bimston can confirm the results of the operation before the patient leaves the operating room.
Thyroid Nodules and Thyroid Cancer
The thyroid is a butterfly-shaped gland located in front of the windpipe, low in the neck. Thyroid nodules are very common growths or lumps in the glands, affecting as many as 1 in 3 adult females. The majority of thyroid nodules are benign (noncancerous). Thyroid cancer is present in only approximately 1 of 20 people with thyroid nodules.
Thyroid Cancer Testing
The only way to be sure that a thyroid nodule is not cancerous is to see an endocrinologist or an endocrine surgeon, who may perform a biopsy in the office. The best test to determine the true nature of a thyroid nodule is a fine needle aspiration biopsy (FNAB) with ultrasound guidance, which is performed if the nodule exceeds a half inch or 10 millimeters in diameter. R. Mack Harrell, MD, at Memorial Center for Integrative Endocrine Surgery, has performed more than 5,000 ultrasound-guided thyroid biopsies since 1991. If a diagnosis of cancer is confirmed, specialized thyroid surgery will be necessary. See how we treat thyroid cancer.
The adrenal glands are two small organs located in the back of the abdomen, right above the kidneys. They are very important in controlling the body's physiologic responses to stress, maintaining blood pressure and producing important hormones. With technically sophisticated CT and MRI scans, adrenal nodules (growths or lumps) can be found in approximately 1 in 10 adults. Most adrenal nodules are completely benign and need no therapy. Adrenal cancers are relatively rare, but can be deadly.
Hormonally Active Adrenal Tumors
Adrenal nodules are often discovered accidentally when patients have abdominal CT scans or MRIs for other conditions. Almost all of these nodules are benign (not cancerous), particularly if they are smaller than 1 inch (3 centimeters) in diameter. However, even small adrenal nodules can cause clinical symptoms by over-producing adrenal hormones like epinephrine, cortisol, aldosterone and testosterone.
Minimally Invasive Adrenal Surgery
Historically, adrenal surgery required a large painful abdominal or back incision and a hospital stay of seven to 10 days. Patients took two to four weeks to recover and return to work. Today, minimally invasive laparoscopic adrenal surgery is performed through three or four tiny incisions (each less than 1 inch in length). Patients usually spend less than 48 hours in the hospital and are back to work in seven to 10 days.
David Bimston, MD, of the Memorial Center for Integrative Endocrine Surgery, has a long and distinguished track record of performing successful minimally invasive adrenal surgery.