Our approach uses minimally invasive surgery
The approach I use for thyroid and parathyroid operations is called "minimally invasive surgery". This method reduces in patient stay to one night and does not involve painful drains. Postoperative pain is minimal as the muscles in the neck are not cut and most incisions for parathyroidectomy and thyroidectomy are only 2 cms long.
Few if any NHS District hospitals have all the facilities to treat the whole range of surgical endocrine problems. The patient must not be upset if they are referred to a big city centre. This is very much in their interests. In my view for safe endocrine surgery to be performed certain basic criteria most be fufilled. There must be 24 hour resident staff. The ward should be experienced in dealing with endocrine cases. There must be an intensive care unit on site that is staffed 365 days in the year. These criteria are always fulfilled by NHS hospitals but may not be in the private sector. Private hospitals outside London do not usually fulfill all these criteria. If the patients has any concerns they should ask and if the "boxes" cannot be ticked go elsewhere. A review in November 2009 showed that patients operated in centres with a low volume of thyroid cancer were likely to have inadequate operations and be at risk of cure. (J.C Lifante et al British Journal Surgery 2009;96:1284-1288)