Per-Olof Hasselgren • Surgeon
The majority of surgical procedures performed by Dr. Hasselgren are related to endocrine surgery and include thyroid, parathyroid, and adrenal gland procedures. In addition, he performs breast and general surgery procedures.
In his role as Director of Endocrine Surgery, Dr. Hasselgren oversees the academic, educational, and developmental activities in the Section of Endocrine Surgery in the Department of Surgery at the Beth Israel Deaconess Medical Center. These activities include a monthly surgery-endocrinology-pathology multi-disciplinary conference, an annual visiting professorship in endocrine surgery, and the maintenance of a prospective database in endocrine surgery. The prospective database, that presently contains information about more than 4,000 patients, has been the basis for multiple research reports during the last several years.
The surgical procedures for thyroid disorders are most commonly either a hemithyroidectomy (removal of half the thyroid gland) or a total thyroidectomy. The majority of the hemithyroidectomies are performed as same-day procedures whereas patients undergoing total thyroidectomies are typically kept over-night for observation. A nerve monitoring device is routinely used during the thyroid procedures to monitor the function of the recurrent laryngeal nerve. The most common indications for thyroid surgery are a solitary thyroid nodule, thyroid cancer, and multinodular goiter.
Patients undergoing parathyroidectomy for hyperparathyroidism typically undergo preoperative localizing studies including parathyroid ultrasound and sestamibi test. If these tests are inconclusive, a 4-dimesional CT is frequently employed for preoperative localization of abnormal parathyroid gland(s). Patients with a single adenoma undergo a “focused parathyroidectomy” (removal of the parathyroid adenoma without further exploration of parathyroid glands) whereas patients with parathyroid hyperplasia (“four-gland disease”) undergo bilateral exploration of all parathyroid glands and a “subtotal parthyroidectomy” (typically removal of 3½ glands). The success of the parathyroidectomy is monitored by intraoperative measurement of parathyroid hormone levels before and after removal of diseased parathyroid gland(s).
Adrenalectomies are routinely performed laparoscopically with a short postopartive hospital stay (typically 1-3 days). When there is suspicion of a malignant adrenal tumor or if the adrenal lesion is large (>8 cm), an open adrenalectomy is most often performed.