Thyroid, Parathyroid and Adrenal Surgery.

Dr Kollias has extensive experience in endocrine surgical conditions. These include surgical disorders of the thyroid, parathyroid and adrenal glands. 

Thyroid Surgery

The thyroid gland is a butterfly-shaped structure located in the lower neck (see diagram) that releases hormones (T3 and T4) that help regulate metabolism. Dr Kollias offers specialist surgical treatment for the following thyroid conditions:

• Goitre (enlarged thyroid gland)
• Thyroid nodules and cysts
• Thyroid cancer
• Grave’s disease/thyrotoxicosis
• Hashimoto’s thyroiditis
• Thyroglossal cyst

Surgery may involve hemithyroidectomy (removal of half the thyroid gland) or total thyroidectomy (removal of all of the thyroid gland) depending on the reason for surgery. The operation is performed under general anaesthesia and performed through a small incision in the lower neck which leaves a scar that is barely visible with time. Dr Kollias uses a capsular dissection technique, which minimises any complications. In selected cases, a nerve integrity monitor is used to minimise the risk of damage to the recurrent laryngeal nerves (nerves to the voicebox) to help maintain voice function. The operation requires 1-2 nights stay in hospital and a two-week recovery period.

Parathyroid Surgery

The parathyroid glands are 4 very small glands, about the size of a rice grain, usually located in the neck (see diagram). These produce parathyroid hormone (PTH) which, together with vitamin D, helps regulate calcium levels in the bloodstream, bones kidneys. The excessive release of PTH by an enlarged parathyroid gland (or multiple glands) may lead to serious illness, kidney disease and osteoporosis which increases fracture risk. If this occurs, parathyroid surgery (parathyroidectomy) may be recommended. Similar to thyroid surgery, this involves a general anaesthesia and a small incision in the lower neck to “explore” all 4 parathyroid glands to remove the gland (s) which are of normal. In some cases, a single abnormal parathyroid gland may be identified with special scans before surgery, allowing Dr Kollias to remove the parathyroid gland using “keyhole surgery”.

Surgery for parathyroid disease is very effective, providing a cure in over 95% of cases. The operation requires 1-2 nights stay in hospital and a two-week recovery period.

Adrenal Gland Surgery

Adrenal glands are small glands located just above the kidneys (see diagram). Adrenal surgery is required in patients with an overactive adrenal gland due to a tumour producing excessive hormones.

 This can lead to:

• Cushing’s syndrome – excess cortisol producing adrenal tumour causing high blood pressure, diabetes, weight gain, moon face, and thin skin.
• Conn’s syndrome – excess aldosterone hormone producing tumour causing fluid and salt retention, and high blood pressure.
• Phaeochromocytoma – excess adrenaline and noradrenaline producing tumour causing very high blood pressure. This is a serious condition affecting your heart.

Dr Kollias works in conjunction with endocrinologists and offers both open and “keyhole” adrenal surgery. He specialises in “keyhole” surgery where the surgery is performed through three small incisions in your back (posterior retroperitoneal minimally invasive adrenal surgery). This technique is associated with less post-operative pain and a quicker return to normal activities in the more conventional approaches. Dr Kollias has been performing this procedure since 2013. The operation requires 2 nights stay in hospital and a two-week recovery period.

Neck Dissection

Neck dissection is an operation where the lymph glands of the neck are removed because of known or suspected cancer that has spread to them. There are several types of neck dissection that are offered, depending on the type and location of cancer:

• Selective neck dissection – where selected groups of lymph glands are removed in different neck locations.
• Comprehensive neck dissection (radical or modified radical) – where the lymphatic tissue and lymph glands are removed in all levels of the neck (upper, mid and lower). If l possible, important structures such as the 11^th cranial nerve (for good shoulder function), and the jugular vein (which helps to reduce facial swelling after surgery by improving blood flow away from the head) are preserved.

Further information about thyroid, parathyroid or adrenal surgery may be obtained through the following reputable websites:

http://www.endocrinesurgeons.org.au/
https://www.iaes-endocrine-surgeons.com/
https://www.thyroid.org/thyroid-surgery/
https://www.baets.org.uk/patients/