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Parathyroidectomy mayo stand and back table surgery setup

Diana Lei-aloha Avatar

setup author

Surgery setup images for Parathyroidectomy

Parathyroidectomy surgery instruments

Clamping & Occluding instruments

Hemostatic Clip Applier
Hemostatic Clip Applier
Rienhoff Swan-Neck Clamp
Rienhoff Swan-Neck Clamp
Right Angle Clamp
Right Angle Clamp
Kelly Forceps
Kelly Forceps
Mosquito Clamp - Curved
Mosquito Clamp – Curved
Allis Forceps
Allis Forceps

Cutting & Dissecting instruments

#3 Knife Handle
#3 Knife Handle
Metzenbaum Scissor
Metzenbaum Scissor
Straight Mayo Scissor
Straight Mayo Scissor

Grasping & Holding instruments

Smooth Adson
Smooth Adson
Adson Forceps
Adson Forceps
Debakey Forceps
Debakey Forceps

Retracting & Exposing instruments

Freer Skin Hook
Freer Skin Hook
Weitlaner Retractor
Weitlaner Retractor
Richardson Retractor
Richardson Retractor
Mahorner Thyroid Retractor
Mahorner Thyroid Retractor
Lahey Thyroid Retractor
Lahey Thyroid Retractor

Suctioning instruments

Yankauer Suction
Yankauer Suction
Ferg-Frazier Suction
Ferg-Frazier Suction

Suturing & Stapling instruments

Ryder Needle Holder
Ryder Needle Holder
Mayo-Hegar Needle Holder
Mayo-Hegar Needle Holder

What to expect during Parathyroidectomy

A Parathyroidectomy is a surgical procedure performed to remove one or more of the parathyroid glands, which are responsible for regulating the calcium levels in the body. This procedure is typically done to treat hyperparathyroidism, a condition where the parathyroid glands produce too much parathyroid hormone, resulting in elevated calcium levels in the blood. The surgery involves making an incision in the neck and dissecting the gland, while ensuring the surrounding structures such as the thyroid gland, nerves, and blood vessels are not damaged.

Position
supine with neck extended

Equipment
nerve monitor probe (surgeon’s preference) I like to keep mine in my bovie holster since they are thin and somewhat sharp

Step 1: Making the Incision
The first step in the Parathyroidectomy procedure is making an incision along the collar in the neck crease using a 15 blade. The surgical technologist must hand the blade to the surgeon while maintaining a sterile field. After making the incision, the surgeon will use small retractors like skin hooks or Richardsons to dissect down to the thyroid.

Step 2: Tying Off Vessels
As the surgeon continues to dissect down to the thyroid, they may come across vessels that require tying off. Surgical technologists must ensure that silk ties are readily available to the surgeon to tie off any vessels that require ligation. It’s crucial to have a variety of different-sized clip appliers available in case the surgeon decides to use them.

Step 3: Obtaining a Baseline Sample
After the thyroid is exposed, the surgical team will take a sample of PTH serum to establish a baseline. The surgical technologist must ensure that the necessary instruments for this procedure, such as a PTH kit and a sterile syringe, are readily available.

Step 4: Dissecting the Gland
The surgeon will continue to dissect the rest of the gland from the thyroid, and another PTH sample will be taken and sent STAT to the lab. During this step, the surgical technologist must ensure that the surgeon has access to the necessary instruments, such as dissectors and scissors.

Step 5: Closing the Incision
Once the gland has been completely dissected, the surgeon will check the PTH levels to ensure they are within an acceptable range. If the levels are good, the incision will be irrigated and closed. The surgical technologist must hand the necessary instruments to the surgeon while maintaining a sterile field.

The Surgery Sparknotes

  1. Make an incision along the collar in the neck crease using a 15 blade.
  2. Ensure silk ties are available to tie off vessels.
  3. Obtain a baseline PTH sample.
  4. Dissect the gland using dissectors and scissors.
  5. Check PTH levels and irrigate and close the incision.

4 responses to “Parathyroidectomy”

  1. Lindy Avatar
    Lindy

    Whats the difference between a parathyroidectomy and a regular thyroidectomy

    1. Diana Lei-aloha Avatar
      Diana Lei-aloha

      Good question! During a parathyroid surgery, the parathyroid gland that is attached to the thyroid is removed, whereas in a thyroidectomy the thyroid itself is removed.

  2. Semira Hassen Avatar
    Semira Hassen

    What kind of sutures used? What medication are on back table Lido or Marcaine?

  3. Semira Hassen Avatar
    Semira Hassen

    What kind of sutures used?

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