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Minimally Invasive Radioguided Parathyroidectomy

  • Matthew D. Cox
  • Brendan C. StackJr.Email author
Chapter

Abstract

Minimally invasive radioguided parathyroidectomy (MIRP) has gained mainstream popularity as a surgical treatment option for primary hyperparathyroidism (1° HPT) caused by a solitary parathyroid adenoma. Compared to the gold standard bilateral neck exploration with parathyroidectomy, advantages of MIRP include shorter operative times, smaller surgical incisions and resulting scars, cost savings, and fewer complications. Imaging techniques remain imperfect, but technological advancements have allowed for continual improvement in the rate of successful preoperative localization of diseased parathyroid glands. Use of 99mTc-sestamibi radionuclide and a handheld gamma probe for intraoperative measurement of sequestered radioactivity allows reliable distinction of parathyroid adenomas from fat, lymph nodes, and normal parathyroid glands. Intraoperative parathyroid hormone (IOPTH) measurement allows for intraoperative confirmation that parathyroid hormone (PTH) levels have been corrected by removal of the offending parathyroid adenoma. In cases where MIRP is technically possible, the rate of cure of 1° HPT is comparable to that of bilateral neck exploration with parathyroidectomy.

Keywords

Parathyroid Gland Parathyroid Adenoma Gamma Probe Preoperative Localization Parathyroid Surgery 
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.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Otolaryngology—Head and Neck SurgeryUniversity of Arkansas for Medical SciencesLittle RockUSA

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