Endocrine surgery

Endocrine surgery
Intervention
Adrenalectomy
ICD-10-PCS	0G
ICD-9-CM	06-07
MeSH	D013507
OPS-301 code	5-06...5-07

Endocrine surgery is a specialized surgical field where procedures are performed on endocrine glands to achieve a hormonal or anti-hormonal effect in the body. Almost always, this entails operating to remove a tumor which has grown on or within an endocrine gland. A common approach is endoscopic endonasal surgery.

Thyroid, parathyroid, and adrenal

The field of endocrine surgery typically comprises surgery for the thyroid gland, parathyroid glands, and adrenal glands.

The most common endocrine surgery operation is removal of the thyroid (thyroidectomy), followed by parathyroid surgery (parathyroidectomy), followed by the rare operation on the adrenal gland (adrenalectomy).

Pituitary, testicles/ovaries, and pancreas

Although not typically referred to as endocrine surgery, it could be argured that surgery of the pituitary gland, testicles, ovaries, and pancreas are also forms of endocrine surgery since these glands are hormone producing glands as well. More classically, however, only thyroid, parathyroid and adrenal surgery are thought of as "endocrine surgery" with pituitary surgery typically thought of as a form of neurosurgery; testicle surgery typically thought of as urologic surgery; ovary surgery typically thought of as a form of gynecologic surgery; and pancreatic surgery typically thought of as oncology surgery.

History and training

Endocrine surgery is in general more recently developed than other fields of surgery.^[1]

Endocrine surgery has developed as a sub-specialty surgical category because of the technical nature of these operations and the associated risks of operating in the neck. Beginning in 1978, specialty training became available in the United Kingdom and later in the USA to help train surgeons within this highly specialized field.The early training center was the Hammersmith Hospital London where under the guidance of Professor Dick Welbourne and Mr John Lynn a large number of Endocrine Surgeons were trained. It is well established that complications are much less common if performed by surgeons who do at least 100 thyroid operations per year.In the United Kingdom most thyroid surgery is performed by surgeons doing less than 20 thyroid operations per year. This results in a high risk of permanent voice change (up to 2%) and a high risk of parathyroid damage. In expert hands these risks should be nearer 0.5%.Permanent damage to both voice box nerves is an extreme rarity and needs in most cases a permanent tracheotomy.

References