Minimally Invasive Parathyroidectomy Publications

UW Publication

Summary

Chen H, Sokoll L, Udelsman R. Outpatient minimally invasive parathyroidectomy: a combination of sestamibi-SPECT localization, cervical block anesthesia, and intraoperative PTH assay. Surgery. 1999; 126:14-18.

This study showed that patients who had a parathyroid removed with a minimally invasive procedure (rather than bilateral neck exploration), had a shorter length of hospital stay (0.3 vs 1.8 days), and lower costs.  There was no difference between cure rates or complications.

Pruhs ZM, Starling JR, Mack E, Chen H. Changing Trends for Surgery in Elderly Patients with Hyperparathyroidism at a Single Institution. Journal of Surgical Research 2005; 127:59-62.

Since the development of minimally invasive radioguided parathyroidectomy, more elderly patients with primary hyperparathyroidism have elected to undergo removal of a parathyroid.  The minimally invasive technique has also resulted in a higher cure rate, less complications, and a shorter hospital stay in elderly patients.

Adler JT, Sippel RS, Chen H. The influence of surgical approach on quality of life after parathyroid surgery. Annals of Surgical Oncology. 2008; 15:1559-1565.

In this study, the quality of life in patients who underwent the older surgical technique of bilateral neck exploration was compared to those who had the minimally invasive technique.  While both groups showed that parathyroidectomy improved quality of life eventually, those who had the minimally invasive surgery had a significantly shorter hospital stay, and faster improvement and recovery.

Pinchot SN, Chen H, Sippel RS. Incisions and Exposure of the Neck for Thyroidectomy and Parathyroidectomy. Operative Techniques in General Surgery. 2008; 10:63-76.

This review notes that the most commonly used incision is horizontal on the front of the neck, and is usually in a pre-existing neck crease so as to reduce visibility of the scar.  Incisions of "minimally invasive surgery" are generally less than 2.5cm long, and can be placed directly over the parathryoid in cases where the location is known prior to surgery.  This allows for the smallest incision.