title: Robotic thoracoscopic mediastinal parathyroidectomy for persistent hyperparathyroidism: case report and review of the literature.
abstract: Recurrent and persistent primary hyperparathyroidism remains a significant surgical challenge. Abnormal, hypersecreting parathyroid glands are found in ectopic locations in up to 15% to 20% of patients. A small portion of these ectopic glands will be found in the mediastinum at a location that precludes removal through the traditional cervical incision. Minimally invasive approaches to these glands are desirable because of the significant morbidity, pain, and hospital stay associated with sternotomy or thoracotomy. Recently, robotic approaches have been described for mediastinal parathyroids. We report a case of young woman with persistent primary hyperparathyroidism who was cured after undergoing robotic thoracoscopic mediastinal parathyroidectomy using radiooperative and intraoperative parathyroid hormone guidance.
authors.affiliation: Division of Endocrine Surgery, Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Harvey
authors.forename: Linda
authors.initials: L
authors.lastname: Bohacek
authors.forename: Donald
authors.initials: D
authors.lastname: Neumann
authors.forename: Tomislav
authors.initials: T
authors.lastname: Mihaljevic
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
mesh_terms: D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery*; D008482:Mediastinum / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D016105:Parathyroidectomy / Q000295:instrumentation / Q000379:methods*; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D013906:Thoracoscopy / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult