As of March 21, 2025, MGH’s main entrance on Coxwell Avenue is closed as the next phase of our redevelopment project begins. Patients and visitors can use the new temporary main entrance on Sammon Avenue between Coxwell Avenue and Knight Street. View our campus map.
Michael ¾ÅÓÎÌåÓý (MGH) has introduced a process for a type of hormone testing that makes parathyroid surgeries significantly more efficient â€� further positioning the hospital as a centre of excellence for endocrine surgery in Ontario.
The process � called intraoperative parathyroid testing � has helped streamline more than 30 parathyroid surgeries at MGH since last summer. This is especially impactful because the hospital performs more than 400 endocrine surgeries a year, a quarter of which are parathyroid surgeries. This is considered a high volume among hospitals in the province.
“The introduction of this testing process is a big deal for our patients and our region,� says Dr. Antoine Eskander, Chief of Otolaryngology � Head and Neck Surgery at MGH. “It helps ensure our patients are cured of hyperparathyroidism and that they do not need additional parathyroid surgeries, which may potentially be higher risk.�
Intraoperative parathyroid testing is a rapid blood test conducted during parathyroid surgery. The surgery aims to address hyperparathyroidism, a condition that happens when the parathyroid glands produce high amounts of parathyroid hormone in the bloodstream. If not treated, this may lead to health issues, such as kidney stones, osteoporosis, high blood pressure, stroke and, in the most severe cases, coma.
The test allows surgeons to confirm within nine minutes during surgery if they have removed all abnormal parathyroid glands causing hyperparathyroidism in a patient. This is important because it is not possible to determine outside of surgery which parathyroid glands are abnormal.
“Before we introduced this process, we needed to perform what’s called a frozen section procedure during parathyroid surgeries,� Dr. Eskander explains. “This involved transferring a tissue sample from the operating room to the lab, so a pathologist could analyze it and inform us if a gland’s tissue is abnormal so we could remove it.
“This procedure took a lot of time � more than 30 minutes � during which we would have the patient under anesthesia in the operating room and many members of the surgery team on standby. More importantly, it was not as accurate at determining cure as intraoperative parathyroid testing.
“With this new process, we’re able to tell through a blood test within minutes if the level of parathyroid hormone in the patient’s bloodstream has decreased to a normal level,� Dr. Eskander continues, “thus making our parathyroid procedures quicker, more efficient and a much better experience for our patients.�
MGH is one of only a handful of hospitals in Ontario that offer intraoperative parathyroid testing. In addition, the nine-minute turnaround time for results is significantly shorter � in some cases, up to 30 to 45 minutes quicker � than at some other hospitals.
The improvement was enabled by the installation of two new pieces of equipment in MGH’s Laboratory Medicine Department. This includes a new, state-of-the-art chemistry analyzer equipped with a module that allows the machine to quickly analyze many blood samples at the same time with a high level of accuracy and minimal risk of cross-contamination.
MGH’s Laboratory Medicine Team also worked closely with the Surgery Team to develop a dedicated process where, as soon as a blood sample arrives in the hospital’s lab for intraoperative parathyroid testing, a lab team member immediately facilitates its processing to further decrease the time that the Surgery Team is awaiting results.
“We’re immensely proud of how our Lab Medicine Team worked together to support the development of this highly streamlined intraoperative parathyroid testing process,� says Andrew Liu, Director of Pharmacy and Laboratory Medicine at MGH. “We know our efforts are making significant improvements in the experiences of our surgery patients. On the lab side, this also reduces our reliance on the frozen section procedure for parathyroid surgeries, allowing us to better reserve this process for other needs.�
With the support of donors to Michael ¾ÅÓÎÌåÓý Foundation, the hospital also acquired a centrifuge, a device that separates the components of a blood sample. The blood obtained for intraoperative parathyroid testing must be processed through the dedicated centrifuge before it goes to the chemistry analyzer.
“This is a powerful example of how philanthropy directly impacts the hospital’s work,â€� says Mitze Mourinho, President of Michael ¾ÅÓÎÌåÓý Foundation. “With the help of donors, we’ve unlocked new efficiencies that get patients in and out of the operating room faster, use less anesthesia and free our team to see to more patients.â€�
The implementation of this intraoperative parathyroid testing process further positions MGH as a provincial leader in endocrine surgeries, which includes thyroid and parathyroid procedures.
Since the process was introduced, the hospital has seen an increase in patients being referred for parathyroid surgery � some of which are more challenging procedures that benefit from this specific testing.
In addition to Surgery and Laboratory Medicine, the initiative involved efforts from the Anesthesia, Nursing and Information Technology Teams.
For Dr. Eskander, it’s a testament to the organization’s collaboration, innovation and “can-do attitude�.
“To me, this is just one example of why MGH is special and excellent at what it does,� Dr. Eskander says. “We come together to do things that few others can do.�