Minimally invasive radioguided parathyroidectomy (MIRP).
The technique of parathyroidectomy has traditionally involved a bilateral exploration of the neck with the intent of visualizing 4 parathyroid glands and resecting pathologically enlarged glands. Parathyroid scanning using technetium-99m sestamibi has evolved and can now localize 80% to 90% of parathyroid adenomas. The technique of minimally invasive radioguided parathyroidectomy (MIRP) is a surgical option for most patients with primary hyperparathyroidism and a positive preoperative parathyroid scan. The technique makes use of a hand-held gamma probe that is used intraoperatively to guide the dissection in a highly directed manner with the procedure often performed under local anesthesia. The technique results in excellent cure rates while allowing most patients to leave the hospital within a few hours after the completion of the procedure. Current data also suggest the procedure can decrease hospital charges by approximately 50%. This technique may significantly change the management of primary hyperparathyroidism.
Goldstein
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Kenneth vonRoenn MD Family Chair in Surgical, Endocrinology and Professor of Surgery, University of Louisville, KY 40202, USA. Richard.Goldstein@louisville.edu
Martin
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Richards
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D004867:Equipment Design; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D007430:Intraoperative Care; D019060:Minimally Invasive Surgical Procedures; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000295:instrumentation / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi