title: The role of the robotic-assisted transaxillary gasless approach for the removal of parathyroid adenomas.
abstract: BACKGROUND
  We sought to describe a robotic technique of transaxillary gasless parathyroidectomy for the management of primary hyperparathyroidism (PHPT) due to a parathyroid adenoma.
  
  
  METHODS
  All consecutive patients who underwent robotic parathyroidectomy for a parathyroid adenoma by a single surgeon were included. Data was obtained by a retrospective review of patients' medical charts.
  
  
  RESULTS
  Nine patients with confirmed PHPT underwent robotic parathyroidectomy. Curative resection was established in all patients with the aid of intraoperative parathyroid hormone monitoring. One patient required bilateral cervical exploration of multiglandular disease. There were no complications. Patients were followed up for a period exceeding 6 months without any evidence of persistent or recurrent hyperparathyroidism.
  
  
  CONCLUSIONS
  Our initial experience demonstrates that this technique is safe and effective for the treatment of PHPT. We believe that the use of robotic technology for endoscopic parathyroid surgeries could overcome the limitations of conventional techniques in the management of parathyroid lesions.
authors.affiliation: Division of Head and Neck Endocrine Surgery, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors.forename: Salem I
authors.initials: SI
authors.lastname: Noureldine
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lewing
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D001365:Axilla; D005260:Female; D006801:Humans; D008297:Male; D010282:Parathyroid Neoplasms / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome