Welcome to EndocrineSurgeon.co.uk

Committed to safety and excellence in minimally invasive endocrine surgery.

Endocrine surgery is the surgery of the thyroid, parathyroid, pituitary, adrenal glands and the endocrine pancreas. It is a highly specialised form of surgery.

This website aims to provide comprehensive, authoritative and up-to-date information on all aspects of endocrine surgery for our patients, medical students and qualified practitioners of all levels. It has been designed by two internationally recognised endocrine surgeons, dedicated to the use of minimally invasive surgery in endocrine conditions, and addresses all areas of the subject from the basic science of endocrinology, to the rarest disorders that an endocrine surgeon would need to treat. 

Our approach is called "minimally invasive surgery", using very small incisions for thyroid and parathyroid operations, and keyhole surgery for the adrenal gland. Having a 10cm incision for ones thyroid, parathyroid or adrenal surgery should be a rarity other than in the most exceptional circumstances. The most common minimally invasive neck surgery is open surgery through a 2cm incision, but we can also perform the surgery by a video assisted method through a similar length incision, where indicated.

We strongly believe, like our American colleagues, that intra-operative recurrent laryngeal nerve monitoring is absolutely mandatory. We use it in every patient having neck surgery. Patients should be warned that the lack of support by NICE in 2008 for the universal use of nerve monitoring in thyroid surgery has legal implications. If it is not used and a patient suffers recurrent nerve damage with the nerve identified only visually that this is cannot be considered a "breach of duty of care". We suggest that patients ask to be operated on by surgeons that use nerve monitoring. We sincerely feel it reduces in expert hands the risk of recurrent nerve palsy.

We have other concerns about the standard of care offered to patients in the UK with endocrine surgical problems. This is particulary true of thyroid cancer, where results of treatment in the UK are significantly worse than those in the USA and Continental Europe. In England only £80 per capita is spent annually on all cancers compared to £121 in France and £143 in Germany. The publication of the UK guidelines for the management of thyroid cancer in 2007 have in part allayed our fears for patients. A matter for grave concern to us is the low volume of thyroid and parathyroid surgery perfomed by a significant number of surgeons in the UK. This is particularly the case in the management of parathyroid tumours. We are regularly asked to explore patients whose first attempt at surgery has failed, all too often due to the inexperience of the initial surgeon.

The British Association of Endocrine and Thyroid Surgeons (BAETS) in 2007 published their 2nd National Audit Report of endocrine surgery in the UK covering the period of 2005-6. Our experience was the largest in the UK in both thyroid and parathyroid surgery, with over 380 endocrine surgical cases treated per year. We operate on over 200 thyroid patients and 120 parathyroid patients per year, as well as performing minimally invasive adrenal and pancreatic endocrine surgery and managing other head and neck endocrine tumours.

 If you have any comments or suggestions for the website, please make contact through the options on the left-hand menu. Your comments help us to maintain the highest possible standard of endocrine surgery.

The Team adheres strictly to the ethical principles laid out in "Good Surgical Practice" published by The Royal College of Surgeons of England in February 2008.

This site is for educational and teaching purposes only. It is in no way intended to replace medical advice given in the consultation room by a qualified doctor. Any individuals with concerns about their health should first consult their physician and then seek an endocrine surgical referral if necessary. We are very happy to give advice via email but will always insist that the local physician is involved where at all possible.