Let's learn about endocrine surgery in simple terms.

You must have heard our friends and relatives talking about things like "thyroid problem" and "neck tumor". Sometimes the doctor says that this requires surgery. It is normal to feel a little scared. But when you are properly informed about these things, you can overcome that fear. Today we are talking about surgeries performed on the glands that produce hormones in our body, that is, 'Endocrine Surgery'.

What is this endocrine system?

Simply put, this is the system of glands in our body that produce hormones. Think of it like a large company's messaging system. These glands release chemical messengers called hormones into the blood. These hormones travel throughout the body and tell each organ to "do this."

So this system controls many important things in our body.

• Physical growth and sexual development
• Breathing
• Metabolism - the process by which we convert the food we eat into energy
• Body movements
• Pregnancy and childbirth
• Our sensations

If this gland doesn't work properly, whether it produces too many hormones or too few, our body loses its balance and disease develops. That's when surgery may be necessary.

Which glands are mainly involved in these surgeries?

Although there are several glands in the endocrine system, surgery is most often required for diseases of three main glands.

1. Thyroid Gland: This is located in the front of our neck, shaped like a butterfly. This is the master of our body's metabolism. It's like the accelerator that controls the speed of a car's engine. This is what determines the rate at which our body uses energy and produces heat.

2. Parathyroid Glands: These are four small pea-sized glands. They are located behind the thyroid gland. Their main function is to control the levels of calcium and phosphorus in the body. This is very important for the strength of our bones.

3. Adrenal Glands: These are located above our kidneys, like two hats. These glands produce sex hormones, as well as hormones like cortisol, which is released when we are stressed. They also help control blood pressure.

What are the common medical conditions that require surgery?

Surgery is often necessary when a gland develops a tumor, becomes cancerous, or becomes overactive and cannot be controlled with medication. Let's look at the main diseases that require surgery for each gland.

Can a doctor who specializes in hormonal diseases perform surgery?

This is a question that many people ask. Endocrinologists are doctors who treat these diseases with medication. They do not perform surgery. If you need surgery, that doctor will refer you to a surgeon . Some hospitals have endocrine surgeons who have received special training in these hormone glands. It is better if they can perform the surgery themselves.

What happens before the surgery?

Your surgeon will clearly explain to you what to do before the surgery.

• You will be asked to fast (abstain from eating or drinking) for a few hours before surgery.
• You may be asked to temporarily stop taking certain medications and vitamins .
• If you smoke, quitting is definitely something you should do.

Also, you will need to undergo several tests to accurately assess your condition.

• Blood tests: Check gland function and hormone levels.
• Imaging scans: An ultrasound, CT scan, or MRI scan can be done to see the exact size and location of the gland or tumor.
• Needle Biopsy: If there is a tumor, this test is done to confirm whether it is cancerous.
• Laryngoscopy: This is done to check the health of your vocal cords, especially before thyroid surgery.

There are several ways the surgery can be performed.

Depending on your condition, your surgeon will choose the most appropriate surgical procedure. There are three main methods.

1. Open Surgery: This is the traditional method. The skin over the gland is cut and the gland is removed directly. This method is necessary for things like large cancerous tumors.

2. Laparoscopic Surgery: This is also called "keyhole surgery." Instead of one large incision, several small incisions are made and a thin tube with a camera is inserted through the incision, and the surgery is performed under the watchful eye of a monitor. This results in less scarring, less pain, and faster healing.

3. Robotic Surgery: This is similar to laparoscopic surgery. However, here the surgeon performs the surgery by controlling a robotic arm. This allows for more precise and precise surgery.

The surgery can usually take anywhere from one to three to four hours, depending on the complexity of your condition. All of these surgeries are performed under general anesthesia, meaning you are given a sedative to put you to sleep . So you won't feel any pain.

What happens after the surgery?

You will need to stay in the hospital for a day or two after the surgery. You may have a slight sore throat and some bruising at the incision site. The doctor will give you painkillers for that.

• A portion of the removed gland is sent to the lab for a biopsy to see if it is cancerous . The results will determine the next course of treatment. For example, if you have thyroid cancer, you may need to undergo radioiodine therapy.
• Sometimes, the hormone produced by the removed gland may need to be taken as a pill for the rest of your life. For example, if your entire thyroid gland is removed, you will need to take the hormone thyroxine every day. It's not that big of a deal, just one pill a day.

Benefits and possible risks of surgery

Like any surgery, these surgeries have benefits as well as some minor risks.

Benefits:

• The disease can be completely cured .
• The symptoms are gone, life is easier.
• If it is cancer, it can be prevented from spreading.
• The risk of developing other diseases such as high blood pressure, heart disease, and osteoporosis is reduced.

Risks:

• Infection.
• Bleeding.
• Damage to nerves near the surgical site. (For example, if the nerve to the vocal cords is damaged during thyroid surgery, the voice may change temporarily or permanently. However, this risk is very low with an experienced surgeon.)
• If the parathyroid glands are removed, the calcium level in the blood decreases (Hypoparathyroidism).

Don't be afraid of these risks. Your doctor will take the necessary steps to minimize all of these.

Recovery time after going home

Take care of these things to recover quickly after you go home.

• Take a good rest for about a week or two and avoid lifting heavy weights.
• Keep the wound clean. Change the dressing as directed by the doctor.
• Things like fluids, cold drinks, and ice chips can help with a sore throat.
• Take the medications, hormone pills, and calcium prescribed by the doctor on time.
• You will usually be able to go back to work in a week or two.

When you need to see a doctor quickly

If you experience any of the following symptoms, call your doctor immediately or go to the hospital's Emergency Department (ETU).

• Swelling, redness, or pus-like fluid draining from the incision site (these are signs of infection).
• Fever.
• Difficulty breathing or a change in voice.
• If you experience numbness or tingling in your face, lips, hands, or feet (this may be a sign of low calcium levels).