Endocrine Surgery

Endocrine surgery is the branch of surgery that operates on hormone-producing glands: the thyroid, the parathyroids, the adrenal glands and hormone-secreting tumours of the pancreas. Surgeons work closely with endocrinologists, because the decision to operate rests on hormone tests as much as on scans.

These operations are delicate because of what lies next to the glands: the voice nerves and parathyroids in the neck, and major vessels around the adrenals. Results are closely tied to how many such operations a surgeon performs each year.

Conditions this service looks after

• Thyroid nodules that are suspicious or proven cancer
• Large goitres causing pressure on the windpipe or gullet
• Graves' disease and toxic nodules not suited to tablets or radioiodine
• Primary hyperparathyroidism with high calcium
• Secondary and tertiary hyperparathyroidism in kidney disease
• Adrenal tumours producing cortisol, aldosterone or adrenaline-type hormones (phaeochromocytoma)
• Adrenal masses that are large or look suspicious
• Insulinomas and other pancreatic neuroendocrine tumours
• Inherited syndromes such as MEN 1 and MEN 2

Tests you may be offered

• Hormone blood and urine tests: Confirm that a gland is overactive before any surgery is planned.
• Neck ultrasound with fine needle aspiration: Grades thyroid nodules and samples those that meet size and appearance criteria.
• Sestamibi scan and 4D CT: Locate an overactive parathyroid gland so the operation can be focused.
• Adrenal CT or MRI: Characterises adrenal masses; adrenal vein sampling shows which side makes excess aldosterone.
• Laryngoscopy: Checks vocal cord movement before and after neck surgery.

Treatments available

• Thyroid lobectomy or total thyroidectomy: Removal of half or all of the thyroid, with lymph node clearance for some cancers.
• Parathyroidectomy: Focused removal of a single adenoma, or four-gland exploration, with hormone levels checked during surgery.
• Laparoscopic or retroperitoneoscopic adrenalectomy: Keyhole removal of an adrenal gland; open surgery for large or invasive tumours.
• Pre-operative medical preparation: Alpha blockers before phaeochromocytoma surgery and antithyroid drugs before Graves' surgery are essential for safety.
• Radiofrequency ablation of thyroid nodules: A needle-based option for benign nodules causing symptoms, in selected cases.

When to ask for a specialist opinion

• A thyroid nodule biopsy reported as suspicious, indeterminate or malignant
• Raised calcium with raised parathyroid hormone
• An adrenal nodule with abnormal hormone tests or larger than about 4 cm
• Difficulty swallowing or breathing from a goitre
• You have been advised surgery and want a second opinion on its extent

Travelling to Türkiye for this care

Planned endocrine operations fit travel well once the diagnosis is secure. Thyroid and parathyroid surgery need about a week in the city and adrenal surgery a little longer. Send your hormone results, ultrasound or CT images and cytology slides ahead so the plan is agreed before you fly. What cannot be done on a visit is the long-term part: thyroid hormone dose adjustment, calcium monitoring, radioiodine decisions and cancer surveillance all need an endocrinologist near home, so set that up beforehand.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions