New doctor at Crouse is an endocrine surgeon, one of the few in Upstate New York. He talks about his specialty, which involves operating on endocrine glands
By Chris Motola
Q: You’re an endocrine surgeon. How rare of a subspecialty is that?
A: Yes, there are relatively few of us across the country.
Q: What kinds of operations do you perform?
A: My specialized training involves operating on endocrine glands, so that includes the thyroid gland, parathyroid gland and the adrenal glands.
Q: What kinds of conditions would necessitate operating on these glands?
A: Thyroid cancers or symptomatic nodules such as a thyroid goiter are common. Sometimes there are functional thyroid nodules. Patients can also see me for parathyroid disease which causes high calcium levels in the blood or adrenal masses which, again, could be functional or non functional.
Q: When you’re operating on these glands, what considerations do you have to make that might be different than with general surgery?
A: The main advantage that my training has brought me is a better understanding of the medical side of the management of these patients, particularly when it comes to treating patients with functional surgical disease.
Q: What got you interested in endocrine surgery?
A: Endocrine surgery was an area of my general surgery residency where I got very good operative exposure and had excellent mentors. I enjoyed the anatomy and the technical aspects of performing the relatively detail-oriented surgeries. And I enjoyed the diversity of patients and disease pathologies I was able to treat as an endocrine surgeon.
Q: And you’re also a general surgeon, correct? Are you also doing general surgery at Crouse?
A: Yes, I am.
Q: What brought you to Crouse and Central New York?
A: I moved here for the job. I was attracted to Crouse because it’s a well-respected health system. It has a positive culture, and I know my patients here are receiving excellent service and care. What most attracted me, though, were my surgical partners who have been very supportive and collaborative. And I also get to work with residents from the Upstate general surgery residency program, which I also enjoy.
Q: Will this be your first time teaching?
A: In an attending role, yes. There’s usually an intern, a second-year and a fourth-year resident who are at Crouse as part of their rotations.
Q: Are outcomes from endocrine surgery usually good?
A: We’re fortunate in that we tend to have very good outcomes even among our thyroid cancer patients. Part of it is the nature of the disease, part of it is because we have very good treatment, including surgery.
Q: What would the process be for a patient leading up to endocrine surgery?
A: Thyroid patients will usually come to see me if they have an enlarged thyroid that’s causing them symptoms or have symptoms related to hyper-secretion of hormones from one or more thyroid nodules. Or, more commonly, they have a nodule that was discovered maybe incidentally. They’ll typically have a fine needle aspiration biopsy before they come to see me and be referred to me depending on the outcome of biopsy. Parathyroid patients typically have undergone a work-up for high calcium levels. Many patients referred for adrenal disease have what we call incidentalomas, which is an adrenal mass which is seen on imaging that was done for something else. The patients with functional adrenal tumors will typically be having symptoms, whether it’s hypertension that’s difficult to control, high blood sugars or fast heart rate.
Q: Are these issues usually resolved by surgery, or do they require additional therapies?
A: It varies. So for thyroid there’s been a lot of emphasis on trying to deescalate the extent of surgery. So typically surgery is part of a multimodal treatment, which may or may not include radioactive iodine. Typically, patients aren’t getting any sort of therapy pre-operatively for thyroid cancer. There are some medications that are used to treat parathyroid disease. Those are usually reserved for patients who aren’t good candidates for surgery or have something called secondary hyperparathyroidism, where the disease is caused by kidney dysfunction rather than the glands themselves.
Q: What kinds of recovery times are we looking at with endocrine surgery?
A: Patients tend to do very well post-operatively. Either they go home the same day or the following day.
Lifelines
Name: Clinton Ingersol, M.D.
Position: Endocrine and general surgeon at Crouse Hospital
Hometown: Mount Vernon, Ohio
Education: Frank H. Netter School of Medicine at Quinnipiac University, New Haven, Connecticut; residency at Riverside Methodist Hospital, Columbus, Ohio; fellowshio: endocrine surgery at University of Miami, Jackson Health, Miami
Affiliations: Crouse Hospital, SUNY Upstate Medical University Hospital
Organizations: American Association of Endocrine Surgeons; American College of Surgeons
Family: Wife, twin boys, one girl
Hobbies: Hiking, cycling, traveling, classical music, spending time with family.