Her Skin Condition Called for ‘Scarless’ Parathyroid Surgery, A First in Florida

About two years ago, Lynette Boodhoo was told by her endocrinologist that he needed to monitor her hyperparathyroidism. But this past January, Mrs. Boodhoo was referred to Robert Udelsman, M.D., MBA, chief of Endocrine Surgery and director of the Endocrine Neoplasia Institute at Miami Cancer Institute.

She would need surgery to remove one of her parathyroid glands, which are right behind the thyroid gland in the neck.

Dr. Udelsman is the first physicians in the U.S. to be fully trained in a new surgical technique that does not leave a visible scar on patients with certain benign and cancerous thyroid and parathyroid conditions. Unlike traditional thyroid or parathyroid surgery, which involves about a two-inch incision in the neck, a surgeon accesses the thyroid or parathyroid glands located on top of the windpipe through the inside of the lower lip.

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[Transcript]
[Baptist Health]

[Robert Udelsman, M.D. Chief of Endocrine Surgery]
I think this is an incredibly interesting case. And the biggest part about the case is this particular patient. Because she came to me with the idea of doing the operation, that's a bit unusual.

[Lynette Boodhoo, Patient]
My skin condition is vitiligo. And every time I get a cut, depigmentation occurs on my skin. So it is like 100% why I wanted the surgery done this way.

[Dr. Udelsman]
So the standard approach for parathyroid surgery is usually by a small incision at the base of the neck and that works well for the vast majority of patients.
[Footage of Dr. Udelsman explaining the technique that will take place to Mrs. Boodhoo]
However, for a subset of patients we've developed other techniques in this case, a trans-oral approach, which is actually goes through the lower lip. We then insert saline through the skin and over the chin.
[Pictures of the instruments that will be used in the procedure]
Then we use three small trocars for which use small instruments. And then the entire operations performed on a video screen using laparoscopic instruments. In this case, pediatric instruments because the instruments are so small.

[Dr. Udelsman
Part of the reason I was so interested in her case is because I think this operation has a lot of issues in it that we can learn for other patients.
[Showing the scars that could happen from the normal way of surgery]
For instance, there are some patients who develop very prominent hypertrophic scars or keloids after neck surgery, some of which are incredibly impressive and very disfiguring. The oral approach would obviate that because you don't heal the same way inside your mouth as you do on your skin of your neck. So I think even though her case might be quite rare, it's definitely the first in Florida. I can say that with total confidence. I can also say it's probably among the top two or three in the world. The implications might be far more common for other patients.

[Lynette Boodhoo]
My advice to anyone who wants to consider this surgery is to have a consult with Dr. Udelsman. Besides having many, many skills, he's just a kind and compassionate person and he listens to you.

[Baptist Health Logo]

[End Transcript]

• Category

  Parathyroid Cancer