Minimally Invasive Right Inferior Parathyroidectomy

Abstract

A minimally invasive parathyroid surgery is a successful parathyroidectomy that is performed through a small incision less than 3 cm in length. In addition to the size of the incision, the extent of surgical dissection to all underlying structures should also be considered. Minimal invasiveness entails a shorter operation and consequently less time under anesthesia, minimal postoperative pain, low incidence of complications, and high long-term success rates. There is no difference in the long-term recurrence rate between a minimally invasive approach and the standard open neck exploration. A minimally invasive technique allows for a targeted surgical approach to the parathyroid adenoma, resulting in a cosmetically appealing as well as curative result. If the patient were to develop recurrent disease after the first parathyroid surgery, the complication rate would increase dramatically if the initial surgery performed was a four-gland neck exploration yielding a complication rate up to 42% versus the minimally invasive approach at 15%. Furthermore, the use of intraoperative parathyroid hormone monitoring showed the cure rate of a minimally invasive parathyroidectomy as high as 97–99%. This chapter describes a removal of the right inferior parathyroid adenoma in 72-year-old female with primary hyperparathyroidism by minimally invasive parathyroidectomy.