scholarly journals Outcomes of minimally invasive parathyroidectomy in pediatric patients with primary hyperparathyroidism owing to parathyroid adenoma: A single institution experience

2017 ◽  
Vol 52 (1) ◽  
pp. 188-191 ◽  
Author(s):  
Edna E. Mancilla ◽  
Michael A. Levine ◽  
N. Scott Adzick
Keyword(s):  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Parathyroid Adenoma ◽  
Pediatric Patients ◽  
Minimally Invasive Parathyroidectomy ◽  
Single Institution ◽  
Invasive Parathyroidectomy

scholarly journals Role of gamma probes in performing minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: optimization of preoperative and intraoperative procedures

2003 ◽  
pp. 7-15 ◽  
Author(s):  
D Rubello ◽  
A Piotto ◽  
D Casara ◽  
PC Muzzio ◽  
B Shapiro ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Parathyroid Adenoma ◽  
Gamma Probe ◽  
Minimally Invasive Parathyroidectomy ◽  
Operating Theatre ◽  
Neck Ultrasound ◽  
Invasive Parathyroidectomy ◽  
Guided Surgery

OBJECTIVE: In the last decade, surgery of primary hyperparathyroidism (HPT) due to a solitary adenoma has moved on from the traditional wide bilateral neck exploration (BNE) to more limited approaches such as unilateral neck exploration and minimally invasive parathyroidectomy. DESIGN: To define the role of intraoperative gamma probe and injection of a low (99m)Tc-MIBI dose in performing minimally invasive radio-guided surgery (MIRS) in HPT patients with a solitary parathyroid adenoma. METHODS: From September 1999 to July 2002, 214 patients with primary HPT entered the study. All patients were preoperatively investigated by a (99m)Tc-pertechnetate/MIBI subtraction scan and high-resolution neck ultrasound. The intraoperative technique we developed differs from other previously described techniques being based on the injection of a low (37 MBq) MIBI dose in the operating theatre a few minutes before the beginning of intervention. RESULTS: On the basis of scan/ultrasound findings 147 patients were selected for a MIRS and 144 of them (98%) were successfully treated by this approach: a solitary parathyroid adenoma was removed through a small 2-2.5 cm skin incision with a mean operative time of 35 min, and a mean hospital stay of 1.2 days. In the other 67 patients with scan/ultrasound evidence of concomitant nodular goiter (n=45) or multi-gland disease (n=13) or with a negative scan (n=9), the gamma probe was utilized during a traditional BNE. A low 37 MBq MIBI dose proved to be sufficient to perform a MIRS; moreover it delivered to the patient and surgeon a low, negligible, radiation exposure dose. CONCLUSIONS: The combination of a (99m)Tc-pertechnetate/MIBI subtraction scan and neck ultrasound appears to be an accurate imaging protocol in selecting primary HPT patients as candidates for a MIRS. A MIBI dose as low as 37 MBq injected in the operating theatre just before the start of surgery appears to be adequate to perform radio-guided surgery.

scholarly journals Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team.

2015 ◽  
Vol 17 (3) ◽  
pp. 315 ◽  
Author(s):  
Omer Uslukaya ◽  
Metehan Gumus ◽  
Bekir Tasdemir ◽  
Cemil Goya ◽  
Faruk Kilinc ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Parathyroid Adenoma ◽  
Local Anesthesia ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Recurrent Laryngeal Nerve Injury ◽  
Minimally Invasive Parathyroidectomy ◽  
Diagnostic Tools ◽  
Usual Practice ◽  
Invasive Parathyroidectomy

Aims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathy- roidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87±14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of bio- chemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87±3.35 min. Post- operative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.

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