Minimally Invasive Parathyroidectomy

  • Ioannis Christakis
  • Fausto Palazzo


The operative management of primary hyperparathyroidism has changed significantly since the first parathyroidectomy performed almost a century ago (Delbridge and Palazzo 2007). The standard procedure has evolved over decades into the bilateral neck exploration (BNE) which involves the careful identification of all parathyroid glands. Abnormal glands are removed and the normal glands are left in situ without biopsy.


Parathyroid Gland Recurrent Laryngeal Nerve Parathyroid Adenoma Parathyroid Surgery Minimally Invasive Parathyroidectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Bilateral neck exploration


Focused anterior approach


Focused lateral approach


General anesthesia


Intraoperative PTH


Local anesthesia


Multiple endocrine neoplasia


Multiple gland disease


Minimally invasive parathyroidectomy


Video-assisted parathyroidectomy


National Institute of Health


Positron emission tomography


Primary hyperparathyroidism


Parathyroid hormone


Sternocleidomastoid muscle


Single-photon emission computed tomography




  1. Agarwal G, Barakate MS, Robinson B, Wilkinson M, Barraclough B, Reeve TS, et al. Intraoperative quick parathyroid hormone versus same-day parathyroid hormone testing for minimally invasive parathyroidectomy: a cost-effectiveness study. Surgery. 2001;130:963–70.PubMedCrossRefGoogle Scholar
  2. Agarwal G, Barraclough BH, Reeve TS, Delbridge LW. Minimally invasive parathyroidectomy using the ‘focused’ lateral approach. II. Surgical technique. ANZ J Surg. 2002;72:147–51.PubMedCrossRefGoogle Scholar
  3. Barczynski M, Konturek A, Hubalewska-Dydejczyk A, Cichon S, Nowak W. Evaluation of Halle, Miami, Rome, and Vienna intraoperative iPTH assay criteria in guiding minimally invasive parathyroidectomy. Langenbecks Arch Surg. 2009;394(5):843–9.PubMedCrossRefGoogle Scholar
  4. Delbridge LW, Palazzo FF. First parathyroid surgeon: Sir John Bland-Sutton and the parathyroids. ANZ J Surg. 2007;77(12):1058–61.PubMedCrossRefGoogle Scholar
  5. Gagner M. Endoscopic parathyroidectomy. Br J Surg. 1996;83:875.PubMedCrossRefGoogle Scholar
  6. Henry JF, Defechereux T, Gramatica L, De Boissezon C. Endoscopic parathyroidectomy via a lateral neck incision. Ann Chir. 1999;53:302–6.PubMedGoogle Scholar
  7. Ismail M, Maza S, Swierzy M, Tsilimparis N, Rogalla P, Sandrock D, et al. Resection of ectopic mediastinal parathyroid glands with the da Vinci robotic system. Br J Surg. 2010;97:337–43.PubMedCrossRefGoogle Scholar
  8. Landry CS, Grubbs EG, Morris GS, Turner NS, Holsinger FC, Lee JE, et al. Robot assisted transaxillary surgery (RATS) for the removal of thyroid and parathyroid glands. Surgery. 2011;149(4):549–55.PubMedCrossRefGoogle Scholar
  9. Mariani G, Gulec SA, Rubello D, Boni G, Puccini M, Pelizzo MR, et al. Preoperative localization and radioguided parathyroid surgery. J Nucl Med. 2003;44(9):1443–58.PubMedGoogle Scholar
  10. Miccoli P, Bendinelli C, Conte M, Pinchera A, Marcocci C. Endoscopic parathyroidectomy by a gasless approach. J Laparoendosc Adv Surg Tech A. 1998;8:189–94.PubMedCrossRefGoogle Scholar
  11. Miura D, Wada N, Arici C, Morita E, Duh QY, Clark OH. Does intraoperative quick parathyroid hormone assay improve the results of parathyroidectomy? World J Surg. 2002;26(8):926–30.PubMedCrossRefGoogle Scholar
  12. Norman J, Chheda H. Minimally invasive parathyroidectomy facilitated by intraoperative nuclear mapping. Surgery. 1997;122(6):998–1003.PubMedCrossRefGoogle Scholar
  13. Sidhu S, Neill AK, Russell CF. Long-term outcome of unilateral parathyroid exploration for primary hyperparathyroidism due to presumed solitary adenoma. World J Surg. 2003;27(3):339–42.PubMedCrossRefGoogle Scholar
  14. Udelsman R, Donovan PI. Open minimally invasive parathyroid surgery. World J Surg. 2004;28(12):1224–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Thyroid and Endocrine SurgeryImperial College NHS TrustLondonUK

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