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Minimally Invasive Parathyroidectomy

UW Health endocrine surgeons in Madison, Wisconsin, perform minimally invasive parathyroidectomy (MIP).

 

This procedure may also be referred to as:

  • MIP
  • Minimally invasive radioguided parathyroidectomy
  • MIRP
  • Focused parathyroidectomy
  • Targeted approach
  • Video assisted

About Minimally Invasive Parathyroidectomy (MIP)

 

MIP is typically performed through a smaller incision than the bilateral exploration, usually 1-3 cm.

 

MIP consists not just of one procedure, but a variety of techniques that can be used either alone or in combination. A central component of each of these techniques is accurate pre-operative localization.

 

A second component, is intraoperative PTH testing.

 

Other adjuncts such as radio-guidance and local anesthesia may also be used.


Cure Rates and Advantages

 

The cure rate of MIP appears to be equal to conventional exploration1-3. There are several potential advantages of MIP over a bilateral neck exploration including:

  • Smaller incision
  • Improved cosmesis
  • Shorter operative time
  • Creation of less scar tissue
  • Fewer problems with low calcium levels after surgery

Incision following a minimally invasive parathyroidectomyThe incidence of symptomatic low calcium levels has been shown to be reduced from 25 percent in a bilateral exploration to 7 percent with MIP1.

 

The ability to perform a MIP under local anesthesia, if desired, is another advantage. MIP has been shown to reduce operating room time by up to 50 percent and almost all patients are able to have their surgery done as an outpatient and go home the same day.


Prior to being considered for a MIP, a patient must have undergone pre-operative localization that reveals a single abnormal gland. An additional peripheral IV is often placed to be used for intraoperative PTH testing.

 

Prior to making an incision a baseline PTH level is drawn from either from a peripheral IV line or a vein in your neck. Minimally invasive parathyroidectomy can be performed through either a medial or lateral approach.