Tobias Carling, MD, PhD, is one of the highest-volume endocrine surgeons in the United States. He cares for people who have conditions that affect the thyroid, parathyroid and adrenal glands. He often performs surgeries that are minimally invasive, laparoscopic or retroperitoneoscopic (similar to laparoscopic procedures, but performed through the back). He treats patients with both benign and cancerous conditions.
Yale Medicine has long been a leader in thyroid, parathyroid and adrenal surgery, says Dr. Carling. In addition to practicing surgery himself, he serves as chief of Yale Medicine Endocrine Surgery. It’s one of the largest practices in the world for parathyroid surgery and one of the largest in the country for adrenal surgery.
“We see a lot of patients with advanced thyroid cancers that require neck dissections—complex operations of the neck designed to make sure we can remove all cancers,” Dr. Carling explains. However, he performs many surgeries using minimally invasive techniques that allow patients to go back to work earlier and feel less pain. For parathyroid disease, surgeries that just a decade ago took three hours under general anesthesia are often done in 15 or 20 minutes with the patient under light sedation. “So there have been lots of innovations in this field,” he says.
Dr. Carling and his team are renowned for having performed the first "scarless" transoral endoscopic thyroidectomies and parathyroidectomies in the world, outside of Asia. The surgery is a way to remove the thyroid and parathyroid glands through an incision in the mouth, with the cosmetic advantage of no neck incision.
“I like to think of myself as a problem solver. I really like to have a perfect plan before going into the operating room,” Dr. Carling says. For instance, if a patient has a complex recurrence of thyroid cancer, he is diligent about studying what happened during the previous operation and later when the cancer comes back. “I want to make sure this is the last and final operation that the patient will have for this,” he says.
In addition to his other roles, Dr. Carling is director of endocrine cancer at the Smilow Cancer Hospital. He also directs the Yale Endocrine Neoplasia Laboratory and is an associate professor of surgery (endocrine) at Yale School of Medicine.