Minimally invasive video‐assisted parathyroidectomy in dogs: Technique description and feasibility study

Abstract

Objective To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism. Study design Surgical technique description and clinical case report. Animals Five canine cadavers and 5 client‐owned dogs with primary hyperparathyroidism. Methods A surgical technique for minimally invasive video‐assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases. Results A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space. Conclusion Minimally invasive video‐assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases. Clinical significance Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs.

Surgical description and outcome of ultrasound‐guided minimally invasive parathyroidectomy in 50 dogs with primary hyperparathyroidism

“…One recent study in canine cadavers and clinical cases adapted and described the technique for minimally invasive video‐assisted parathyroidectomy 22 . While it demonstrated that the technique was feasible in dogs, information such as signalment, histological diagnosis, and clinical outcomes were unlikely representative of the general population due to the small number of cases 22 .…”

“…One recent study in canine cadavers and clinical cases adapted and described the technique for minimally invasive video‐assisted parathyroidectomy 22 . While it demonstrated that the technique was feasible in dogs, information such as signalment, histological diagnosis, and clinical outcomes were unlikely representative of the general population due to the small number of cases 22 . Minimally invasive video‐assisted parathyroidectomy has a steep learning curve (utilization of potential space and not the natural body cavity, stabilization of the scope in the absence of cannulas) and requires specialized equipment that are designed specifically for the procedure 22 .…”

“…20,21 The technique was adapted to five cadavers and five clinical cases in a recent study investigating the feasibility of minimally invasive video-assisted parathyroidectomy in dogs. 22 While the results suggested that minimally invasive parathyroidectomy is feasible in dogs, the low number of cases was a major limitation. 22 It has been shown in human studies that compared to bilateral neck exploration, minimally invasive parathyroidectomy has the advantage of decreased surgical time, improved patient comfort, and lower complication rates.…”

“…22 While the results suggested that minimally invasive parathyroidectomy is feasible in dogs, the low number of cases was a major limitation. 22 It has been shown in human studies that compared to bilateral neck exploration, minimally invasive parathyroidectomy has the advantage of decreased surgical time, improved patient comfort, and lower complication rates. Therefore, minimally invasive parathyroidectomy should be explored as an option to treat PHPT in dogs.…”

“…Minimally invasive video‐assisted parathyroidectomy was first developed in dogs to study its feasibility in humans 20,21 . The technique was adapted to five cadavers and five clinical cases in a recent study investigating the feasibility of minimally invasive video‐assisted parathyroidectomy in dogs 22 . While the results suggested that minimally invasive parathyroidectomy is feasible in dogs, the low number of cases was a major limitation 22 …”