Overview
“American Hospital Tbilisi” – AHT, offers treatment of endocrinological pathologies by international standards and the latest medical technological means, both surgically and mini-invasively or laparoscopically.
Endocrinology surgery focuses on surgery of the hormone-producing glands of the human body:
- Thyroid gland;
- Parathyroid glands;
- Adrenal glands;
- Pancreas glands.
Surgical and minimally invasive methods:
- Open surgery – unilateral and complete excision of the thyroid gland, complete thyroidectomy with regional lymph nodes;
- Excision of parathyroid adenomas.
- These procedures are conducted transversely, with a small collar rate, on the anterior surface of the neck (called the Kokher method).
- Mini-invasive method – thyroid surgeries;
- Adrenal surgery – performed without rate, by laparoscopic method.
Outpatient services of the Endocrinology Department are:
- Thin-needle aspiration biopsy of the thyroid gland or lymph nodes with cytology / ultrasound control;
- Sclerotherapy of thyroid cysts (ethanol ablation).
- Preoperative diagnosis and management of the patient is carried out by an individual approach, by the so-called “Thyroid Group”.
“Thyroid Group”:
- Endocrinologist;
- Surgeon;
- Radiologist;
- Cytologist;
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Inpatient service – surgical treatment:
- Hemithyroidectomy;
- Complete thyroidectomy;
- Complete thyroidectomy, central lymph node dissection;
- Complete thyroidectomy, central and neck lateral lymph resection;
- Bilateral lymph node dissection;
- Excision of parathyroid glands;
- Adrenal gland surgery – operations are performed by minimally invasive or laparoscopic method.
Surgical treatment of surgical pathologies of the thyroid gland according to the European standard – using microdissection method and intraoperative neuromonitoring;
Microdiction terminology – The use of binocular surgical glasses (2.5 times magnification of the operating field) implies a sparing and complete dissection of the tissues, which is the primary condition for the operation during the malignant process. In addition, identifying inverted nerves and parathyroid glands and avoiding or minimizing their trauma;
Intraoperative neuromonitoring – This method involves continuous monitoring of the inverted laryngeal nerve (Nervus laryngeus recurrens) during surgery with special electrodes and apparatus to rule out functional and anatomical damage to this nerve. Maintain the function of the vocal cords so that the tone of voice does not change or the breathing becomes difficult after the operation.
According to official WHO statistics, the incidence of thyroid diseases (F / J) is exceptionally high worldwide.
Thyroid disease is one of the most prevalent endocrinological disorders, ranking second only to diabetes in terms of prevalence, according to the International Health Organization.
Thyroid cancer is the third most common type of cancer in Georgia.
Pathologies of the thyroid and near thyroid glands:
- Benign nodular diseases of the thyroid gland;
- Toxic goiter (Graves’ disease);
- Diffuse hyperplasia and hypothyroidism;
- Malignant diseases of the thyroid gland;
- Restrosternal and / or ectopic thyroid gland;
- Parathyroid adenoma and carcinoma.
Benign tumors of the adrenal gland:
- Hyperaldosteronism;
- Cushing’s syndrome;
- Pheochromocytoma;
- Adrenal hyperplasia (unilateral);
- Risk of malignancy of 3-6 adrenal neoplasms 10-2%.
Malignant tumors of the adrenal gland:
- Primary, adenocortical carcinoma (ACC) 0.7-2%;
- Secondary metastatic lesions (malignant tumors of the kidney, lung, and colon, melanoma, and lymphoma).
Tumors of the pancreas:
- Insulinoma;
- Gastrinoma;
- Glucagonoma;
- Vipoma.
– How long will I be required to remain at the clinic?
– You will be hospitalised for 48 hours.
– What type of anaesthetic is used during the procedure?
– The procedure is carried out under general endotracheal anaesthesia (2-3 hours).
– Will I experience pain following the operation?
– Analgesics are used to relieve minimal postoperative pain.
– Which drugs should I take following surgery?
– During the postoperative period, you will receive thyroxine and calcium as thyroid hormone replacement therapy.
– Am I going to require stitches? Scar or no scar?
– The postoperative wound is aesthetic – unnoticeable after three months.
– Will I lose my voice following the procedure?
– In 1% of cases, a transitory shift in the tone of voice occurs, which resolves completely within a few weeks.
– What are the symptoms of low calcium levels in the blood and when will I require calcium supplementation?
– Numbness in the limbs, fingertips, and lips is a sign of low calcium levels in the blood, which is why calcium supplements are necessary.
– Will the operation result in physical limitations?
– Within 3-5 days of the operation, physical limits will be erased and you will return to normal.
– Why is the area around the wound swollen?
– Postoperative wound swelling is a natural response to tissue stress; it is reduced with specific gels and resolves in 10-14 days.
Endocrinological surgery offers complete laboratory and instrumental examinations of the thyroid and thyroid glands and if necessary – fine needle aspiration biopsy – cytological examination. This determines the risk of malignancy of the nodal structures according to the classification – Bethesda (The Bethesda System for Reporting Thyroid Cytology – TBCRTC) recognized by the World Health Organization.
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