Smaller than peas, the four parathryroid glands in the neck play an important role in the human body. The parathyroid hormone (PTH) they produce acts directly on the kidneys and bone to regulate serum calcium levels, and indirectly on the gastrointestinal tract to enhance the intestinal absorption of calcium.

When one of these tiny glands becomes overactive due to a tumor and produces too much hormone, it can be a significant health risk for the patient and a challenge for the surgeon to remove, explains Michael Demeure, MD, professor and the new chief of the Division of General Surgery at Arizona Health Sciences Center. The overproduction of PTH can cause weakening of the bones, kidney stones, muscle weakness, depression and stomach problems. About one in every 1,000 women and one in every 2,000 men have hyperparathyroidism, the most common cause of hypercalcemia (a high level of calcium in the bloodstream).

Standard treatment for primary hyperparathyroidism is to surgically remove the enlarged gland that is overproducing the hormone. Finding the culprit has been a challenge in the past because the location of the tiny parathyroids varies within the neck. The surgery involved general anesthesia, a three-inch incision, and often one to two hours of surgery to find the enlarged gland. Patients usually stayed in the hospital for one or two days. "In some cases, the enlarged gland was not found," Dr. Demeure says.

Now, the STAT-Intraoperative System makes it possible for Dr. Demeure and other endocrine surgeons to reduce surgery time and help ensure that the offending gland is found and removed.

Prior to surgery, the patient is given a weak radioactive substance. A hand-held gamma probe is then used to pinpoint the location of the parathyroid tumor. The surgeon makes a small incision and removes the gland. The STAT-Intraoperative-System monitors the parathyroid hormone concentration in the blood during surgery. The system serves as a minilab, allowing surgeons to perform the test in the operating room where the test result is needed. A rapid decrease of the parathyroid hormone level signifies that the gland removed was the culprit and no other parathyroid glands are diseased.

With only a one-inch incision needed, the procedure now can be performed with the patient awake and under local anesthesia. The patient usually goes home the same day. "Using this technology avoids the need for more extensive neck exploration for the tumor and a possible second parathyroidectomy," says Dr. Demeure.

EDITORS PLEASE NOTE: Video of the procedure and the device is available. Patient interviews can be arranged by calling Jo Marie Gellerman at 626-7219.

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