Minimally Invasive Thyroid Surgery Leads to Healthier Life for Patient

BAdamsTwenty three-year-old Rebecca Adams had never heard of a parathyroid adenoma. It was only during lab work for an unrelated medical issue that the condition presented itself. Her lab results showed elevated calcium and parathyroid hormone (PTH) levels, two tell-tale signs that something was amiss with her parathyroid glands.

A Team Approach to Care

Rebecca was referred to Alexandra Dresel, M.D., F.A.C.S., a general surgeon on the medical staff at Texas Health Presbyterian Hospital Dallas and one of the area’s highest-volume parathyroid surgeons. Dr. Dresel performed parathyroid hormone testing on Rebecca and made the diagnosis of a parathyroid adenoma.

“The diagnosis sounded so ominous at first,” Rebecca said. “Then I talked about what it meant with Dr. Dresel and did a lot of research. It was rather unusual for someone my age to have this condition but I realized that I could power through the diagnosis and subsequent surgery, with the right doctors on my side.”

The parathyroid glands produce PTH to help control the amount of calcium and phosphorus in the blood. When a tumor exists, these mineral levels are disrupted and the affected gland releases more PTH than it should, a condition known as hyperparathyroidism. A parathyroid adenoma is a noncancerous tumor of the parathyroid glands. According to the National Institutes of Health, if not removed, the condition can lead to osteoporosis (thin bones), an increased risk for fractures and kidney stones.

“In most people with hyperparathyroidism, the abnormal gland is in the neck and surgery is always the recommended treatment for anyone under the age of 50,” Dr. Dresel said. “Of the hundred or so parathyroid surgeries I perform each year, only one or two are located in the mediastinum ― the area of the chest cavity between the lungs ― and a chest surgeon’s assistance is required. Such was the case with Rebecca.”

Dr. Dresel reached out to thoracic surgeon Mark Pool, M.D., of Cardiac, Vascular & Thoracic Surgical Associates, a Texas Health Physicians Group practice, also on the medical staff at Texas Health Dallas. The two surgeons mapped out a strategy for pinpointing the exact location of Rebecca’s tumor and its removal using robotic surgery – the least invasive approach possible.

Calling on Advanced Surgical Technology

Dr. Pool is one of a handful of thoracic surgeons in Dallas-Fort Worth with expertise in robotic surgery, a sophisticated and minimally invasive technique offered to surgeons at Texas Health Dallas to expand their capabilities in the operating room. Prior to this surgical technique, a tumor such as Rebecca’s required checking all four of the parathyroid glands during surgery. But thanks to the advanced robotic procedure, Dr. Pool made use of the system’s high-definition 3D camera and flexible wristed instruments to find, reach and remove the tumor with enhanced precision and control. The entire procedure was performed through just several small incisions (about the size of peas) made in Rebecca’s chest.

“If we had performed traditional open-incision surgery, we wouldn’t have located the abnormal gland and she would have needed a second invasive surgery,” according to Dr. Dresel.

“With robotic technology available to us today, we have the ability to offer patients with complex conditions better outcomes, reduced pain and shorter recovery times. Rebecca’s adenoma was not easy to find, even with the robot. Without the use of the technology, I might have had to make a vertical incision along her sternum to access the chest and locate the adenoma ― in which case, the recovery would have been very different,” Dr. Pool added.

A Healthier Time

Living up to its reputation, Rebecca was amazed by what little pain and downtime she had with this advanced procedure. She went home four days after surgery and was quickly able to resume normal activities.

“I can’t say enough about the care I received from doctors Dresel and Pool, along with the employees at Texas Health Dallas,” Rebecca said. “I will always be grateful to everyone who helped me get through this challenging experience and come away healthier.”

Physicians employed by Texas Health Physicians Group practice independently and are not employees of the hospital or Texas Health Resources.


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