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Results of Video-assisted Parathyroidectomy: Single Institution’s Six-year Experience

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Abstract

Endoscopic surgery for primary hyperparathyroidism (PHPT) started in 1996 with a parathyroidectomy performed by Michel Gagner. The technique we propose and have been using for 6 years is based on a unique central access and external retraction. From February 1997 to October 2003, 370 of 520 patients affected with PHPT (71%) underwent minimally invasive video-assisted parathyroidectomy (MIVAP). There were 72 men and 298 women, with a mean age of 55.8 years. Twenty-four patients (6.5%) of the 370 in this series underwent MIVAP under loco-regional anesthesia, and the others had general anesthesia. Eleven patients were lost to follow-up. Surgical cure of PHPT was achieved in 353 patients (98,3%), as confirmed by a median follow-up of 35.1 months (range: 2–82 months). Video-assisted exploration was successfully performed in 350 patients (94%). The mean operative time was 36.2 minutes. In 21 cases (5.6%) a concomitant procedure was performed: a thyroid lobectomy in 14 cases and a total thyroidectomy in 7 cases. Patients were generally discharged the day after surgery. Most of the patients (91%) were satisfied with the cosmetic result 6 or more months after the procedure. Complications developed in 14 cases: 10 cases (2.7%) of transient hypoparathyroidism 3 cases (0.8%) of definitive palsies of the recurrent nerve, and 1 case of postoperative bleeding (0.27%). After 6 years of experience, MIVAP appears to be as safe and curative as traditional surgery, with better cosmetic results and better postoperative outcome.

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Authors and Affiliations

  1. Department of Surgery, University of Pisa, Via Roma 67, 56100, Pisa, Italy

    Paolo Miccoli M.D., Piero Berti M.D., Gabriele Materazzi M.D., Marco Massi M.D. & Michele N. Minuto M.D.

  2. Department of Endocrinology, University of Pisa, Via Paradisa 100, 56123, Pisa, Italy

    Antonella Picone M.D.

Authors
  1. Paolo Miccoli M.D.
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  2. Piero Berti M.D.
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  3. Gabriele Materazzi M.D.
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  4. Marco Massi M.D.
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  5. Antonella Picone M.D.
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  6. Michele N. Minuto M.D.
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Correspondence to Paolo Miccoli M.D..

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Miccoli, P., Berti, P., Materazzi, G. et al. Results of Video-assisted Parathyroidectomy: Single Institution’s Six-year Experience. World J. Surg. 28, 1216–1218 (2004). https://doi.org/10.1007/s00268-004-7638-3

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