Endocrine surgery
Encyclopedia
Endocrine surgery is a specialized surgical field where procedures are performed on endocrine glands to achieve a hormonal or anti-hormonal effect in the body. Almost always, this entails operating to remove a tumor which has grown on or within an endocrine gland.
The most common endocrine surgery operation is removal of the thyroid (thyroidectomy
), followed by parathyroid surgery (parathyroidectomy
), followed by the rare operation on the adrenal gland (adrenalectomy
).
are also forms of endocrine surgery since these glands are hormone producing glands as well. More classically, however, only thyroid, parathyroid and adrenal surgery are thought of as "endocrine surgery" with pituitary surgery typically thought of as a form of neurosurgery; testicle surgery typically thought of as urologic surgery; ovary surgery typically thought of as a form of gynecologic surgery; and pancreatic surgery typically thought of as oncology surgery.
Endocrine surgery has developed as a sub-specialty surgical category because of the technical nature of these operations and the associated risks of operating in the neck. Beginning in 1978, specialty training became available in the United Kingdom and later in the USA to help train surgeons within this highly specialized field. It is well established that complications are much less common if performed by surgeons who do at least 100 thyroid operations per year.In the United Kingdom most thyroid surgery is performed by surgeons doing less than 20 thyroid operations per year. This results in a high risk of permanent voice change (up to 2%) and a similar risk of parathyroid damage. In expert hands these risks should be nearer 0.5%.Permanent damage to both voice box nerves is an extreme rarity and needs in most cases a permanent tracheotomy.
Thyroid, parathyroid, and adrenal
The field of endocrine surgery typically comprises surgery for the thyroid gland, parathyroid glands, and adrenal glands.The most common endocrine surgery operation is removal of the thyroid (thyroidectomy
Thyroidectomy
A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland...
), followed by parathyroid surgery (parathyroidectomy
Parathyroidectomy
Also known as "Parathyroid gland removal", Parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone. As drugs such as Fosamax do not treat the...
), followed by the rare operation on the adrenal gland (adrenalectomy
Adrenalectomy
Adrenalectomy is the surgical removal of one or both adrenal glands. It is usually advised for patients with tumors of the adrenal glands. The procedure can be performed using an open incision or laparoscopic technique....
).
Pituitary, testicles/ovaries, and pancreas
Although not typically referred to as endocrine surgery, it could be argured that surgery of the pituitary gland, testicles, ovaries, and pancreasPancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...
are also forms of endocrine surgery since these glands are hormone producing glands as well. More classically, however, only thyroid, parathyroid and adrenal surgery are thought of as "endocrine surgery" with pituitary surgery typically thought of as a form of neurosurgery; testicle surgery typically thought of as urologic surgery; ovary surgery typically thought of as a form of gynecologic surgery; and pancreatic surgery typically thought of as oncology surgery.
History and training
Endocrine surgery is in general more recently developed than other fields of surgery.Endocrine surgery has developed as a sub-specialty surgical category because of the technical nature of these operations and the associated risks of operating in the neck. Beginning in 1978, specialty training became available in the United Kingdom and later in the USA to help train surgeons within this highly specialized field. It is well established that complications are much less common if performed by surgeons who do at least 100 thyroid operations per year.In the United Kingdom most thyroid surgery is performed by surgeons doing less than 20 thyroid operations per year. This results in a high risk of permanent voice change (up to 2%) and a similar risk of parathyroid damage. In expert hands these risks should be nearer 0.5%.Permanent damage to both voice box nerves is an extreme rarity and needs in most cases a permanent tracheotomy.