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An endocrine surgeon is a surgical sub-specialist who trains in the diagnosis and surgical management of conditions and illnesses that affect the endocrine organs. These are organs that secrete hormones into the bloodstream of the body and regulate certain bodily activities and functions such as metabolism, sensory perception, growth and development, tissue function, digestion, respiration, sleep, mood, stress, reproduction, lactation, excretion and movement.
The endocrine glands that are operated on by these surgeons include the thyroid gland, parathyroid glands, pancreas and adrenal glands. Endocrine diseases and disorders that need medical treatment are managed by specialist physicians known as endocrinologists, and they refer patients to endocrine surgeons where medical therapy is not successful and they therefore need further surgical intervention.
In order to qualify as an endocrine surgeon, a doctor must complete certain mandatory training programmes and degrees. These include completing a 5-6 year surgical and medical undergraduate degree where the medical student qualifies as a medical doctor. This is then followed by exposure to various medical and surgical disciplines when performing a 1-2 year internship phase.
The qualified doctor is then allowed to specialise further, and they will enter and complete a 5 year general surgery residency where they will qualify as a general surgeon. The surgeon will then have to complete a 2 year fellowship in endocrine surgery in order to become such a surgeon.
Conditions managed and procedures performed by Endocrine Surgeons
The following section will discuss the endocrine pathologies encountered by an endocrine surgeon and the procedure(s) they will perform on these patients.
Surgery on the thyroid gland entails removing most of this organ's tissue when patients are diagnosed with conditions such as a multi-nodular goitre and thyroid cancer.
The types of procedures performed by these specialists on the thyroid gland include complete removal of the organ (total thyroidectomy), partial removal of the gland (hemi-thyroidectomy or thyroid lobectomy) and incomplete resections of the thyroid (near-total or sub-total thyroidectomy). The latter though aren't performed as commonly as the other and have fallen out of favour with the endocrine surgeons.
Rarely do conditions involving the pancreas occur that they need surgical intervention, but there are cases that do need this therapy and they include gastrinomas and insulinomas. The surgical procedures performed on the pancreas can range from large resections of the organ to simple tumour enucleation.
The human body has four small parathyroid hormones that are located behind each corner of the thyroid gland. The removal of one or many of these glands is called a parathyroidectomy and will be performed in patients diagnosed with primary hyperparathyroidism.
Primary hyperparathyroidism is usually caused by a parathyroid adenoma, where one of these glands converts into a benign tumour that enlarged and then causes parathyroid hyperactivity. In this case, only the pathological mass will be removed.
Conditions such as a pheochromocytoma, Conn syndrome and adreno-cortical cancer warrant the removal of an affected adrenal gland, and the procedure is called an adrenalectomy.