title: Advantages of a video-assisted approach to parathyroidectomy.
abstract: In recent years the advances in preoperative localization studies, the availability of intraoperative parathyroid hormone (PTH) assay and the introduction of cervicoscopy revolutionized the surgical treatment of primary hyperparathyroidism (PHPT). Several endoscopic and video-assisted techniques for parathyroidectomy have been described. In spite of the enthusiasm manifested by some authors, the role of these techniques with respect to the time-honored conventional surgery have been largely debated. Among them, video-assisted parathyroidectomy (VAP) has emerged as one of the leading and more diffuse techniques. To date many large and comparative studies have shown that VAP is an efficacious and feasible procedure with the same complication rate as conventional surgery. Moreover, VAP seems to have significant advantages in terms of cosmetic results, postoperative pain, recovery, and patient satisfaction. When compared with other minimally invasive techniques, it offers the significant advantages of being more similar to conventional surgery and reproducible in different surgical settings. Moreover, it permits bilateral neck exploration, associated thyroid resections and can be performed under locoregional anesthesia. All these characteristics and the excellent results obtained render VAP a valid and well-validated, and even preferable, alternative to conventional surgery for the surgical treatment of sporadic PHPT, especially in case of suspected single adenoma.
authors.affiliation: Division of Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Celestino Pio
authors.initials: CP
authors.lastname: Lombardi
authors.forename: Marco
authors.initials: M
authors.lastname: Raffaelli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Traini
authors.forename: Carmela
authors.initials: C
authors.lastname: De Crea
authors.forename: Salvatore Maria
authors.initials: SM
authors.lastname: Corsello
authors.forename: Liliana
authors.initials: L
authors.lastname: Sollazzi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pontecorvi
authors.forename: Rocco
authors.initials: R
authors.lastname: Bellantone
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010279:Parathyroid Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome; D020535:Video-Assisted Surgery