Minimally invasive parathyroidectomy using the 'focused' lateral approach. II. Surgical technique.
BACKGROUND
This paper describes the technique of minimally invasive parathyroidectomy. The technique is based on a thorough understanding of the anatomy of the fascial planes in neck, the surgical pathology and embryology of parathyroid glands and precise anatomical interpretation of preoperative localization studies.


METHODS
Tissue trauma is minimized by using a 2.0 cm incision placed directly over the abnormal parathyroid gland and by removing the adenoma, without compromising the basic endocrine surgical principles of identification and preservation of recurrent laryngeal nerve, avoidance of any capsular breech, and ligation of the vascular pedicle.


CONCLUSIONS
With proper patient selection, this technique results in a failure rate of less than 4% and ensures that the incidence of complications, such as recurrent laryngeal nerve injury, remains comparable with that of standard open parathyroidectomy.
Agarwal
Gaurav
G
Department of Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Barraclough
Bruce H
BH
Reeve
Tom S
TS
Delbridge
Leigh W
LW
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D018579:Patient Selection