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  • Title: Minimal-access/minimally invasive parathyroidectomy for primary hyperparathyroidism.
    Author: Palazzo FF, Delbridge LW.
    Journal: Surg Clin North Am; 2004 Jun; 84(3):717-34. PubMed ID: 15145230.
    Abstract:
    Minimal-access or minimally invasive parathyroidectomy is replacing a bilateral neck exploration as the surgical approach of choice in primary hyperparathyroidism (pHPT). When a parathyroid adenoma is localized preoperatively, ideally with sestamibi combined with ultrasonography, results equivalent to a bilateral neck exploration can be achieved through an incision less than 2.5 cm. Minimal-access techniques offer the advantage of cure under local anesthesia with a smaller incision and no overnight stay. Intraoperative measurement of parathyroid hormone (PTH) may be a valuable adjunct to confirmation of parathyroid adenoma removal, but currently appears to add little when preoperative localization is optimized. Controlled studies and long-term follow-up will be required to establish the true value of parathyroid minimal-access surgery.
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