Minimally invasive video-assisted parathyroidectomy

One hundred thirty seven cases of minimally invasive video-assisted parathyroidectomy (MIVAP) for primary hyperparathyroidism performed during the last 3 years are analyzed. All patients were referred for primary hyperparathyroidism and had undergone a pre-operative localization study. The procedure is performed by a gasless video-assisted technique through a single 1.5-cm central skin incision above the sternal notch. Quick intraoperative PTH assay was used in 134 cases (97.8%). Mean operative time was 54.3 minutes. The conversion rate was 8.8%. It was registered one recurrent nerve palsy (0.7%) and one case of persistent hyperparathyroidism. Two thyroid lobectomies were associated using the same minimally invasive access. The cosmetic results were excellent. MIVAP can boast the same results as traditional surgery offering additional advantages such as a better cosmetic result and less postoperative discomfort. Not all cases of PHPT can be eligible for MIVAP but in this series more than 70% of the patients were successfully operated on with this technique.